Abstract

SSPE PRESENTED AS CATATONIA: CASE REPORT

*Dr. Prachi Jain, Dr. Anish Sehgal, Dr. Keshvi Purohit and Dr. Cyril Sajan

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Abstract

Catatonia is an unusual clinical presentation of subacutesclerosingpanencephalitis (SSPE), especially in the initial stages of illness. Many patients present with primary psychiatric symptoms like delusions, hallucinations, behavioral and personality changes etc. create complications to the treating physician as to whether these symptoms are due to organic diseases affecting the brain or primary psychiatric illnesses. Subacute Sclerosing Panencephalitis (SSPE) is usually seen in children and adolescents affecting the Central Nervous System caused by measles virus. A 18-year-old boy with no past or family history of psychiatric illness presented with complaints of complete muteness, tightening of body and maintaining same body posture. He was taken to a Psychiatrist where he was prescribed Tab Levatiracetam(250) in night and Tab Iron/folic acid and MRI was done which came to be normal. He also had history of fever 3 days back. By now, he would also urinate in his clothes. Self-care Impaired, he was taken to the casualty. Case was seen by a Neurologist who made a provisional diagnosis of Functional Neurological Symptom Disorder and patient was transferred to the Psychiatry unit. Patient was admitted and a detailed history was taken. A working diagnosis of catatonia was kept and tab lorazepam(1) was given. Following this, patient was referred back to a Neurologist and EEG was performed which showed periodic stereotyped high voltage complexes suggestive of SSPE.

Keywords: Catatonia, Subacute Sclerosing Panencephalitis(SSPE), Functional Neurological Symptom Disorder.