RESUMEN
BACKGROUND: Subacute sclerosing panencephalitis (SSPE) is a complication of measles, occurring after a latency of 4-10 years. It continues to occur in developing countries although resurgence is being reported from developed countries. Characteristic features include progressive neuropsychiatric issues, myoclonus, seizures, movement disorders and visual impairment. Electroencephalography (EEG) typically shows periodic generalized discharges, and elevated CSF anti-measles antibodies are diagnostic. Movement disorders are being increasingly recognized as part of the clinical spectrum, and range from hyperkinetic (chorea, dystonia, tremor, tics) to hypokinetic (parkinsonism) disorders and ataxia. OBJECTIVES: This article aims to comprehensively review the spectrum of movement disorders associated with SSPE. METHODS: A literature search was conducted in PubMed and EMBASE databases in December 2023 and articles were identified for review. RESULTS: Movement disorders reported in SSPE included hyperkinetic (chorea, dystonia, tremor and tics), hypokinetic (parkinsonism), ataxia and extraocular movement disorders. Myoclonus, a core clinical feature, was the most frequent "abnormal movement." Movement disorders were observed in all clinical stages, and could also be a presenting feature, even sans myoclonus. Hyperkinetic movement disorders were more common than hypokinetic movement disorders. An evolution of movement disorders was observed, with ataxia, chorea and dystonia occurring earlier, and parkinsonism later in the disease. Neuroradiological correlates of movement disorders remained unclear. CONCLUSION: A wide spectrum of movement disorders was observed throughout the clinical stages of SSPE. Most data were derived from case reports and small case series. Multicentric longitudinal studies are required to better delineate the spectrum and evolution of movement disorders in SSPE.
Asunto(s)
Trastornos del Movimiento , Panencefalitis Esclerosante Subaguda , Humanos , Corea/etiología , Corea/fisiopatología , Corea/diagnóstico , Distonía/etiología , Distonía/fisiopatología , Electroencefalografía , Trastornos del Movimiento/etiología , Trastornos del Movimiento/fisiopatología , Trastornos del Movimiento/diagnóstico , Mioclonía/etiología , Mioclonía/fisiopatología , Panencefalitis Esclerosante Subaguda/complicaciones , Panencefalitis Esclerosante Subaguda/diagnóstico , Panencefalitis Esclerosante Subaguda/fisiopatología , Temblor/etiologíaAsunto(s)
Neuromielitis Óptica/complicaciones , Espasmo/etiología , Adulto , Femenino , Humanos , Imagen por Resonancia Magnética , Metilprednisolona/uso terapéutico , Neuromielitis Óptica/diagnóstico por imagen , Espasmo/diagnóstico por imagen , Espasmo/tratamiento farmacológico , Médula Espinal/diagnóstico por imagenRESUMEN
Both akinetic and hyperkinetic movement disorders may rarely be the presenting feature of human immunodeficiency virus (HIV) infection. The possible pathogenic basis is the involvement of subcortical structures by the HIV infection-related pathology. Opportunistic infections, or mass lesions complicating HIV infection. In addition dopaminergic dysfunction and medications may also play a role. We report a HIV infected male who presented with progressive choreoathetoid movements and dystonia. He had remarkable improvement of the movement disorder with tetrabenazine and anti-retroviral therapy (HAART) treatment.
