A 9-year-old boy presents with progressive intellectual deterioration, myoclonic jerks, and personality change over 8 months. He had uncomplicated measles at age 2 years. EEG shows periodic burst suppression complexes. Which finding would best confirm the diagnosis?

• A Positive heterophile antibody test
• B Isolation of measles virus from CSF culture
• C Detection of oligoclonal bands specific to mumps virus
• D Raised anti-measles antibody titre in the CSF ✓

Explanation

Subacute sclerosing panencephalitis develops 5 to 10 years after an apparently uncomplicated measles infection and is caused by a defective, persistent measles virus in neurons. The diagnostic hallmark is a markedly raised anti-measles antibody titre in both serum and CSF along with periodic EEG complexes. Live virus is not recoverable from CSF, which kills option B.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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