DOI: https://doi.org/10.36347/sjmcr.2026.v14i05.038

Pages: 1023-1025

Post-measles encephalitis (PME) is a rare inflammatory demyelinating complication in young adults, whose global resurgence necessitates increased vigilance in intensive care settings. We report the case of an 18-year-old patient admitted for febrile encephalopathy (Glasgow Coma Scale [GCS] 9), complicated by status epilepticus and persistent akinetic mutism. Despite a marked systemic inflammatory response (CRP 89 mg/L, leukocytes 20,650/mm³), cerebrospinal fluid (CSF) analysis was strictly normal, illustrating a major clinico-biological discordance. Brain magnetic resonance imaging (MRI) was the key diagnostic modality, revealing diffuse cortical and subcortical T2/FLAIR hyperintensities suggestive of an ADEM-like pattern. This observation highlights that normal CSF findings should not exclude the diagnosis in the presence of critical neurological symptoms. Management relies on intensive neuroprotective strategies, strict seizure control, and early imaging, while vaccination remains the only effective preventive measure against these devastating forms.