Epidemiology
Etiology
Pathophysiology
Clinical features
Mnemonic
烧三天、疹三天、退三天
- Prodrome (eg, cough, coryza, conjunctivitis, fever, Koplik spots)
- Maculopapular exanthem
- Cephalocaudal & centrifugal spread
- Spares palms & soles
Complications
Subacute sclerosing panencephalitis (SSPE)
- Definition: a lethal, generalized, demyelinating inflammation of the brain caused by persistent measles virus infection
- Pathophysiology: It is thought to be caused by a form of measles virus with a mutated or absent matrix protein that prevents mature (enveloped) virion particles from forming. However, the virus continues to replicate intracellularly, leading to a persistent, nonproductive infection that evades eradication by the immune system. Accumulation of viral nucleocapsids within neurons and oligodendrocytes results in the formation of intranuclear inclusions and eventually leads to inflammation, demyelination, and gliosis in many cerebral areas.
- Clinical presentation: characterized by four clinical stages
- Usually develops ≥ 7 years after measles infection
- Stage I: dementia, personality changes
- Stage II: epilepsy, myoclonus, autonomic dysfunction
- Stage III: decerebration, spasticity, extrapyramidal symptoms
- Stage IV: vegetative state, autonomic failure
- Prognosis: SSPE leads to death within 1–3 years of diagnosis)