Merck Manual

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Progressive Rubella Panencephalitis

By

Brenda L. Tesini

, MD, University of Rochester School of Medicine and Dentistry

Last review/revision Jun 2021 | Modified Sep 2022
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Progressive rubella panencephalitis is a neurologic disorder occurring in children with congenital rubella. It is presumably due to persistence or reactivation of rubella virus infection.

Most viruses that infect humans can affect both adults and children and are discussed elsewhere in THE MANUAL. Viruses with specific effects on neonates are discussed in Infections in Neonates Overview of Neonatal Infections Neonatal infection can be acquired In utero transplacentally or through ruptured membranes In the birth canal during delivery (intrapartum) From external sources after birth (postpartum) Common... read more . This topic covers a viral infection that is typically acquired during childhood.

Diagnosis of Progressive Rubella Panencephalitis

  • Cerebrospinal fluid (CSF) examination and serologic testing

  • CT

  • Sometimes brain biopsy

The diagnosis of progressive rubella panencephalitis is considered when a child with congenital rubella develops progressive spasticity, ataxia, mental deterioration, and seizures. Testing involves at least CSF examination and serologic testing. CSF total protein and globulin and rubella antibody titers in CSF and serum are elevated.

CT may show ventricular enlargement due to cerebellar atrophy and white matter disease.

Brain biopsy may be necessary to exclude other causes of encephalitis or encephalopathy. Rubella virus usually cannot be recovered by viral culture or immunohistologic testing.

Treatment of Progressive Rubella Panencephalitis

  • Symptom management

No specific progressive rubella panencephalitis treatment exists. Symptoms (eg, seizures, muscle spasticity, weakness) are managed as appropriate.

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