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In Reply.—
We wish to thank Toro et al for bringing to our attention the Latin American literature on SSPE, which was not available to us during the preparation of our recent article. The Latin American cases of SSPE, which exhibited substantial spontaneous long-term improvement, certainly warrant further follow-up. Elevated measles antibody titers in serum and spinal fluid would be most important in the confirmation of the clinical and EEG diagnoses in these cases. The other epidemiological observations mentioned by Toro et al are most interesting, and we will comment on them in a forthcoming paper on the epidemiology of SSPE in the Middle East.