The Anti-Vaccine Legacy: Re-Emergence of Subacute Sclerosing Panencephalitis in Children

Background: Subacute sclerosing panencephalitis (SSPE) is a chronic, progressive disease of the central nervous system (CNS) caused by persistent infection at this level with the wild measles virus. Its incidence is correlated with measles vaccination coverage. The pathogenesis isn't fully understood, but infection before the age of 2 is an important risk factor. Methods: This is a retrospective observational study conducted at the Louis Turcanu Children's Hospital in Timisoara, Romania, based on the analysis of the medical records of patients diagnosed with SSPE between January 2021 and December 2025. We analyzed demographic and epidemiological factors, clinical and paraclinical findings, management, and outcomes. Results: Seven children were diagnosed during the study period, with a mean age of 8.4 years (range 7-11 years). Six of them had contracted measles during their first year of life, and one at the age of four. The mean latency period was 7.1 years (range 4-9 years). On admission, all patients presented symptoms consistent with clinical stage II, with periodic slow wave discharges on electroencephalogram (EEG). The initial brain Magnetic Resonance Imaging (MRI) was normal in two cases, while revealing varied abnormalities in all others. Despite complex treatment with isoprinosine and anticonvulsants, progressive cognitive and neurological deterioration continued in all patients. Conclusions: SSPE is a rare but serious, debilitating disease despite its complex, multidisciplinary care. Following a 10-year SSPE-free period, the reappearance of these pediatric cases constitutes a public health alert, unequivocally demonstrating the importance of measles vaccination.