Subacute sclerosing panencephalitis (SSPE) In Iraq
Journal Title: IOSR Journals (IOSR Journal of Computer Engineering) - Year 2015, Vol 17, Issue 6
Abstract
Objective: Subacute sclerosing panencephalitis (SSPE) is a progressive inflammatory disease of the central nervous system with poor prognosis and high mortality, caused by the persistent infection with measles virus(MV). Despite much research into SSPE, its pathology remains obscure. Only 5% of individuals with SSPE undergo spontaneous remission, with the remaining 95% dying within 5 years of diagnosis. The prevalence ofthe disease varies depending on the measles vaccine immunization status. The clinical manifestations occur, on an average 6 years after measles virus infection and may initially present with a varied clinical picture ranging from psychiatric to ophthalmological to neurological symptoms and signs. The diagnosis is based upon characteristic clinical manifestations of myoclonus, the presence of characteristic periodic EEG discharges, and demonstration of raised antibody titer. We are reporting 8 cases of Iraqi patients with SSPE and we describe the test methodology used for detection of MV in those patientsMethods: Cerebral spinal fluid (CSF) and 5 ml of blood sample obtained from eight patients from those attended the neurology unite- Baghdad Teaching Hospital in the Medical City during the period from October 2010 to November 2013, were enrolled in this study, their ages were ranged between 7-10 years, with an average age of 8.2 years. Enzyme linked immunosorbent assay (ELISA) were used for the detection of anti-measles virus IgG by the use of Bio ELISA Kits (Biokit S.A.Spain) , the positive results were confirmed by (RT-PCR) technique((DYNAL kits,USA) .Protein electrophoresis were done for all CSF samples and oligoclonal bands (OCB) were detected by isoelectric focusing (IEF). Results: ELISA technique showed that, 8(100 %) of SSPE patients were positive for serum and CSF anti- MV IgG . Those patients were subjected to PCR techniques as a confirmatory test. The results showed that all patients with positive result for IgG was positive for MV genomic DNA. Five patients (62.5%) showed evidence of oligoclonal bands (OCB). Conclusion: This study showed that,The increased risk of developing SSPE after measles virus infection in young children underscores the importance of childhood immunization programs that decrease measles virus transmission and, therefore, reduce the risk of exposure to measles among infants. The success of global programs to eliminate measles will not only prevent the severe complications and death associated with acute cases of measles but will also prevent the devastating disease SSPE . in addition, the overall relative sensitivity of PCR for detection SSPE were found to be 100%.
Authors and Affiliations
Dr. Akram M. Al-Mahdawi, , Dr. Anmar O. Hatem , Dr. Eman Sh. Mahmood
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