Sequential 3-D MRI frontal volume changes in subacute sclerosing panencephalitis

In patients with subacute sclerosing panencephalitis, clinical stages defined according to Jabbour correlate strongly with frontal lobe dysfunctions. Nonquantitative radiologic investigations in these patients have confirmed cerebral atrophy without identifying predominantly affected regions. We addressed this issue over an 8-year-old boy's course using volumetry based on three-dimensional T1-weighted gradient echo magnetic resonance imaging. Seven normal 6-12-year-old subjects served as controls. Whole-brain volume declined as Jabbour stage advanced from I to III. Frontal lobe volume and frontal-to-whole-brain volume ratios fell significantly as clinical stage progressed. Thus, cerebral atrophy in this SSPE patient was predominantly frontal, and paralleled clinical progression.