Parkinsonian presentation of SSPE: Report of two cases

Abstract

Subacute sclerosing panencephalitis (SSPE) is a disease caused by defective measles virus. It is usually characterized by progressive dementia; incoordination and generalized myoclonic jerks. Although atypical presentations are known to occur, parkinsonian presentation at the onset is rare. We report two cases of SSPE who developed parkinsonian features before the onset of psychointellectual impairment and myoclonus. We hypothesize that this may indicate upward spread of the virus from the upper brainstem, in contrast to the usual downward spread from the cerebral cortex.