A 7-year-old boy with a history of measles at age 2 years now presents with progressive intellectual decline, myoclonic jerks, and behavioral changes over 6 months. EEG shows periodic high-voltage complexes. What is the most likely diagnosis?

• A HIV encephalopathy
• B Progressive rubella panencephalitis
• C Subacute sclerosing panencephalitis ✓
• D Creutzfeldt-Jakob disease

Explanation

Subacute sclerosing panencephalitis is a rare, late complication of measles occurring years after the initial infection. It is characterized by progressive cognitive decline, myoclonus, and a characteristic EEG pattern of periodic complexes. Progressive rubella panencephalitis is associated with congenital rubella, not wild-type measles. HIV encephalopathy and Creutzfeldt-Jakob disease have different clinical and EEG features.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.