Abstract Details

Title Our Experience with Combination Therapy and it’s Outcomes in Pediatric Subacute Sclerosing Panencephalitis: A Retrospective Case Series

Topic Child Neurology and Developmental Neurology

Presentation(s) P11 - Poster Session 11 (11:45 AM-12:45 PM)

Poster/Presentation
Number 8-001

Objective To evaluate the clinical profile and therapeutic response to a novel 4-drug combination protocol in paediatric SSPE patients from a low-resource setting.

Background

SSPE is a rare but progressive, and universally fatal, complication of measles that is poorly responsive to treatment with antiviral and immunomodulatory therapies. In view of the recent outbreaks of measles and SSPE in some continents (including North America), there is an urgent requirement for new treatment strategies. In our unit, we developed a combined treatment protocol based on insights from pre-existing literature.

Design/Methods This is a retrospective case series including six children diagnosed with SSPE between 2021 and 2024 based on Dyken's criteria. All of them received monthly doses of intrathecal interferon alpha-2B (1.2 million IU), along with daily oral ribavirin (15 mg/kg), isoprinosine (50 mg/kg), and levamisole (2.5 mg/kg). Neurological status was monitored using Jabbour staging, EEG, MRI, and Neurological Disability Index scores.

Results All 6 Patients (mean age 7.7 years) presented at Stage II or higher. While all patients demonstrated transient improvement in myoclonus and cognition by the 2nd-3rd dose there was uniform deterioration thereafter. All of them eventually succumbed to the disease within a year either due to aspiration pneumonia or sepsis. Notably all fundoscopic abnormalities were noted and a steady progression was noted in all.

Conclusions Combination therapy offered only transient benefit and failed to alter the trajectory of the disease. Our findings highlight the urgency of early diagnosis and reinforce the fact that measles vaccination is the only effective preventive strategy against SSPE.

Authors/Disclosures
Bagath Srinivasan Balaji, MBBS PRESENTER	Dr. Balaji has nothing to disclose.
Ranjith K. Kumar Manokaran, MD	Dr. Kumar Manokaran has nothing to disclose.
Deepti Kewalramani, MD, MBBS	Dr. Kewalramani has nothing to disclose.
Lakshmi N. Ranganathan, MD, PhD, FAAN	Dr. Ranganathan has nothing to disclose.
Latha Ravichandran, MD	Prof. Ravichandran has nothing to disclose.
Elayaraja Sivaprakasam, MBBS, DNB (Ped), MRCPCH	Dr. Sivaprakasam has nothing to disclose.
Sarala Premkumar, MD	Dr. Premkumar has nothing to disclose.
Hemanth Kumar Arumugam, MBBS	Dr. Arumugam has nothing to disclose.

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