Intravenous with intrathecal interferon in subacute sclerosing panencephalitis

Recent literature from different countries has revealed variable results of interferon treatment in subacute sclerosing panencephalitis (SSPE). Twelve patients with SSPE were treated at NIMHANS by concurrent use of intravenous and intrathecal interferon ALFA-2a, manufactured by recombinant DNA technology. The diagnosis of SSPE was based on clinical profile, EEG, CT and presence of anti measles IgG antibodies in CSF. The total dose of interferon by intrathecal as well as intravenous route varied from 15 million to 60 million units. Clinical improvement as demonstrated by a decrease in scores on Neurological disability index occurred in three. Two of them relapsed five months after stopping the therapy but one patient maintained improvement two years after stopping treatment. There was no significant change in six patients. There were 3 deaths. One of them was autopsied. A decrease in titres of antimeasles antibody in CSF was noted in two patients who showed clinical improvement, but in others there was no consistent correlation. No significant changes occurred in EEG during the treatment period. No serious side effect of interferon were encountered. Two patients had iatrogenic meningitis which could be treated successfully. Use of intravenous combined with intrathecal interferon is not promising in SSPE.