SUBACUTE SCLEROSING PANENCEPHALITIS PRESENTING WITH PSYCHOSIS AND POSSIBLE SEXUAL ABUSE

A previously healthy 8-year-old girl began to experience nightmares, s oon followed by sleeplessness and perceptual abnormalities including v isual hallucinations. She also complained that she had been attacked a nd possibly assaulted sexually. Physical investigations were considere d to have provided no relevant abnormality and psychiatric enquiries w ere begun directed towards possible sexual abuse. However, the child's mental and physical state continued to deteriorate and evidence of a progressive organic process was then obtained from past school reports , review of the initial EEG findings and further EEG investigations. T he latter in particular indicated a diagnosis of SSPE which was confir med immunologically. Treatment was ineffective and the child died 7 mo nths after the onset of the illness. The details of the psychological changes at the onset of SSPE are ill-defined. This case illustrates th at they can include psychotic phenomena but also that the basic nature of the disorder may be misconstrued as psychological depending on the circumstances.