Bilateral Vision Loss and Visual Hallucinations in Subacute Sclerosing Panencephalitis: A Case Report

ABSTRACT

We report an interesting case of visual loss and visual hallucinations in a 37-year-old man. He presented with decreased vision in both eyes and visual hallucinations for the last one and a half months. He also had multiple focal to bilateral tonic-clonic seizures. On examination, there was no perception of light rays in both eyes. Fundus examination revealed disc oedema with peripapillary small haemorrhages in both eyes. Initially, the discs were hyperaemic, which turned pale in the subsequent examination at 1 month. Magnetic resonance imaging (MRI) of the brain revealed T2 hyperintensities in periventricular white matter and right fronto-parietal-occipital gray matter. His electroencephalogram showed intermittent slowing. His cerebrospinal fluid (CSF) examination showed five cells (all lymphocytes), protein 50 mg/dl, sugar 76 mg/dl (corresponding blood sugar 90 mg/dl). His CSF specimen was positive for anti-measles IgG antibodies. In conclusion, acute vision loss can rarely be the presenting symptom and, therefore, SSPE should also be considered in differential diagnoses of acute vision loss in measles-endemic regions.

KEYWORDS:

• Measles
• subacute sclerosing panencephalitis
• optic neuritis

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author/Co-author contributions

Ravi Uniyal: Acquisition of clinical and electronic data, Conception, and drafting of the manuscript

Ravindra Kumar Garg: Analysis of clinical and electronic data and drafting of the manuscript

Hardeep S Malhotra: Analysis of clinical and electronic data and drafting of the manuscript

Neeraj Kumar: Analysis of clinical and electronic data and drafting of the manuscript

Shweta Pandey: Analysis of clinical and electronic data and drafting of the manuscript

Imran Rizvi: Analysis of imaging and drafting of the manuscript

Amita Jain: Analysis of lab reports and drafting of the manuscript

Nidhi Tejan: Analysis of lab reports and drafting of the manuscript

Rupesh Singh Kirar: Analysis of imaging data and drafting of the manuscript

Additional information

Funding

The author(s) reported that there is no funding associated with the work featured in this article.