A 10-year-old boy presents with progressive myoclonus, seizures, and cognitive decline over 2 years. He had measles infection at age 2. EEG shows periodic complexes. CSF shows elevated gamma globulin. Brain biopsy would most likely reveal:

• A Perivascular pseudorosettes and ependymoblasts
• B Spongiform change with amyloid plaques
• C Intranuclear Cowdry type A inclusions in neurons and glia with gliosis ✓
• D Non-caseating granulomas with multinucleated giant cells

Explanation

This describes subacute sclerosing panencephalitis (SSPE), a late complication of measles infection caused by defective measles virus persistence. Pathology shows intranuclear Cowdry type C inclusions in neurons and oligodendrocytes, gliosis, neurofibrillary tangles, and inflammation. The periodic EEG complexes and elevated CSF gamma globulin are characteristic. Spongiform change is seen in CJD. Pseudorosettes are seen in ependymoma. Granulomas are seen in tuberculosis or sarcoidosis.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.