亜急性硬化性全脳炎

BACKGROUND: Deduplication is usually treated as a routine preprocessing step in systematic reviews, yet errors introduced at this stage are not visible in Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) flow diagrams and can propagate through evidence synthesis. OBJECTIVE: To evaluate the validity and reproducibility of commonly used deduplication tools in a paediatric neuroradiology systematic review. MATERIALS AND METHODS: PubMed and Embase were searched for peer-reviewed literature on paediatric subacute sclerosing panencephalitis neuroimaging, yielding 603 records. Two reviewers independently deduplicated the combined corpus using Zotero (version 8.0.4) and Rayyan (updated 21 January 2026). A manual reference standard was established by dual-reviewer adjudication of potential duplicate pairs using title, publication year, author list, and Digital Object Identifier (DOI). Tool outputs were compared against this reference standard for false-positive and false-negative decisions and for reproducibility across runs. RESULTS: Manual adjudication identified 120 true duplicate records, leaving 483 unique records. Zotero produced identical outputs across reviewers, indicating deterministic behaviour, but generated 16 false-positive duplicate decisions and 5 false negatives, predominantly related to DOI collision. Rayyan identified more true duplicates but produced non-identical outputs across independent runs, with 16-17 false positives and 1 false negative per run. CONCLUSION: Commonly used deduplication tools can introduce either deterministic bias or non-deterministic record loss before screening begins. In paediatric radiology evidence synthesis, the deduplication software version and verification strategy should be explicitly reported. Auditable secondary checks should be considered before records are removed.

Subacute sclerosing panencephalitis (SSPE) is a progressive neurological complication of measles infection and movement disorders are commonly seen in this condition. We describe an 11-year-old boy with SSPE, with mixed movement phenomenology, including dystonia, slow as well as brief myoclonus, repetitive behaviours, and peculiar periodic vocalizations, which followed the slow myoclonic jerks, and discuss possible mechanisms.

Despite the availability of a safe and effective measles vaccine for several decades, measles remains a significant cause of morbidity and mortality worldwide, causing 95,000 deaths in 2024 alone. Currently, there is no licensed therapeutic agent against measles, and treatment is only supportive. This is a review of articles published from 2015 to 3 June 2025, on therapeutic agents used or under investigation against measles. Ribavirin has been used in severe measles cases; nevertheless, there are no randomized clinical trials so far. New delivery systems, such as polymer-based formulations and nanoparticles, have markedly increased ribavirin's efficacy, while cytotoxicity remained low. Viral membrane fusion (F) protein inhibitors and viral RNA polymerase inhibitors are promising next-generation therapeutics against measles and have been tested in animal models with good results. Lastly, interferons (IFNs) are key mediators of the innate immune response against measles, particularly for controlling brain infection. There are few reports indicating that repeated remdesivir courses, as well as intraventricular or intrathecal ribavirin or IFN, may temporarily stabilize the neurologic status of patients with subacute sclerosing panencephalitis. Intracranial administration of protein F inhibitors also demonstrated promising results in mice. Although several antiviral agents and natural products exhibit in vitro efficacy against measles virus, further research is required to determine their safety, pharmacological properties, and clinical efficacy before they can be considered therapeutic options. Overall, the development of antiviral agents against measles has been extremely slow. Therapeutic agents against measles are urgently needed.