Subacute sclerosing panencephalitis (SSPE) usually presents insidiously. Acute presentations with
a fulminant course can occur. However hyper acute presentations with a non-progressive course
have not been reported. Here we describe two cases that had hyper acute presentation with occipital
involvement misdiagnosed initially as ischemic infarct. One case remained stable for 4 years and then
had a fulminant course and patient succumbed; the other patient continued to remain stable at 2 year
follow up. In countries where SSPE is prevalent, it is important to be aware of such a variant of SSPE.
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