Anesthetic management in patients suspected of Creutzfeldt-Jakob disease -A case report-

In, Chi Bum; Choi, Younghoon; Park, Eun Young; Chang, Dong Jin; Lee, Soo Kyung; Choi, Hyun-Soo; Moon, Hyun Soo

doi:10.4097/kjae.2011.61.3.262

Cited by 7 publications

(7 citation statements)

References 9 publications

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“…In another case report by McMurran et al, the authors also concluded with the same hypothesis of accelerated progression of CJD [5]. Similarly, it reflects that in this case report, there may be a sudden surge in systemic inflammatory mediators due to COVID infection, which might have led to the early demise of the patient despite our best efforts incorporating a multimodal approach consisting of remdesivir 100 mg, convalescent plasma therapy, methylprednisolone 62.5 mg, and LMWH 60 mg (0.6 ml) along with regular physical therapy, dietary, nutritional supplements, and standard ICU care as per the standard protocol [6][7][8].…”

Section: Discussionmentioning

confidence: 90%

“…In such conditions, all necessary measures should be taken to substantially minimize the possibility of transmission between CJD patient and hospital worker and the number of staff in contact to be kept in minimal. Farling et al in a practical guide reported localization of small prions in equipment's microscopic crypts and their resistant nature to all sterilization techniques, including high dose ionizing radiation, ultraviolet radiation, and autoclaving [7]. In sCJD, along with COVID-19, we must advise remdesivir, plasma therapy, methylprednisolone, and LMWH.…”

Section: Discussionmentioning

confidence: 99%

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A case report of sporadic Creutzfeldt-Jakob disease in an Asian origin coronavirus disease-19 patient: An enigma

Choudhary¹,

Sonkar²,

Saxena³

2021

IJCR

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reutzfeldt-Jakob disease (CJD) is a rare, degenerative, fatal brain disorder affecting about one in every 1 million persons/year worldwide [1]. It is the prototype of a family of rare and fatal human degenerative conditions characterized by progressive brain dysfunction. CJD falls into four categories: sporadic, familial, iatrogenic, and variant. Sporadic CJD (sCJD), thought to occur worldwide, is the most common form and represents about 85% of all CJD cases; the incidence ranges between 0.5 and 1.5 cases per million inhabitants per year [2]. An early diagnosis is important for counseling the patient and their family members, as also for optimal management of symptoms and to avoid any iatrogenic transmission. However, any delay in diagnosing the disease is due to a combination of its rarity as well as heterogeneity in the early stages of the disease [3].We report our coronavirus disease (COVID-19) intensive care unit experience in a patient of sCJD who presented with respiratory symptoms and seizures, which were different from the typical neuropsychiatric presentation of sCJD. Hence, we describe the challenges faced in diagnosis, management, and precautionary measurements taken for such a patient, whose condition got aggravated and worsened by the concurrent COVID-19. CASE REPORTA 61-year-old female presented with symptoms of heaviness over the base of the head which progressively worsened over 2 months, along with difficulty in walking, "tremulousness" and low-grade fever on and off. Gradually, she developed a few episodes of confusion with irrelevant and abnormal behavior which worsened over a week along with visual hallucinations.The clinical presentation of the patient suggested some neurodegenerative disease for which, she was referred to the Institute of Human Behavior and Allied Sciences, Delhi, India, where the diagnosis of CJD was made based on the clinical symptoms, typical electroencephalograph (EEG), and magnetic resonance imaging (MRI).The patient was admitted for the above complaints, where she was clinically suspected to be a case of autoimmune encephalitis. Contrast-enhanced MRI was done which revealed empty "sella turcica," and she was treated with methylprednisolone and intravenous immune globulin. The patient's condition showed little improvement for a while and later started to develop

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

A case report of sporadic Creutzfeldt-Jakob disease in an Asian origin coronavirus disease-19 patient: An enigma

Choudhary¹,

Sonkar²,

Saxena³

2021

IJCR

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“…Because of expected airway difficulties after extubation, fully monitored overnight surveillance in an isolated room was scheduled. Setup for anesthesia was prepared according to In's article [7]. Non-ferromagnetic standard monitoring (Precess, Invivivo Corp., Orlando, FL, USA) was connected.…”

Section: Anesthesiological Preparations and Proceduresmentioning

confidence: 99%

Functional Magnetic Resonance Imaging in the Final Stage of Creutzfeldt-Jakob Disease

et al. 2020

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Sporadic Creutzfeldt-Jakob disease (sCJD) is a rare fatal degenerative disease of the central nervous system. The clinical course is characterized by rapid progression of neurological and neuromuscular symptoms. The late stage with loss of consciousness is not well characterized. We report a 62-year-old male patient with sCJD with the clinical picture of a vegetative state/apallic syndrome, in whom we studied cortical responses using a vibration paradigm. The functional magnetic resonance imaging (fMRI) investigation demonstrated a clear response within the sensorimotor cortex, the cerebellum, the parietal cortex, the insular, and frontal inferior region. The finding of persistent cortical activity on fMRI in a patient with CJD in a state of unconsciousness has implications for the clinical management and for ethical considerations.

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“…Cover all other equipment, the walls, the bed, and the floor of the working area with sheets of polyvinyl chloride (Figure 3). 59,60 Another neuroscience center has used disposable liquid‐repellent sheets (eg, surgical drapes and heavy‐duty surgical table covers) to achieve the same goal.These efforts have been shown to facilitate relatively easy disposal of potentially contaminated material 53 …”

Section: Perioperative Implicationsmentioning

confidence: 99%

Special Needs Populations: Perioperative Care of the Patient With Creutzfeldt‐Jakob Disease

Karasin¹

2014

AORN Journal

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Creutzfeldt-Jakob disease (CJD) is a rare but lethal prion disease. The worldwide mortality rate of CJD is 1.67 per one million people, although 90% of cases will lead to death within one year of symptom onset. Rapid, progressive dementia is the cardinal sign of CJD. Other early symptoms include deterioration of muscle coordination, memory, judgment, and vision, as well as personality changes, insomnia, and depression. It occurs in two types, classic and new variant, and classic CJD can be further divided into three subtypes: sporadic, familial (ie, genetic), and iatrogenic (ie, health care associated). Surgery often requires using instruments that come in contact with high-infectivity tissue, especially during neurosurgical procedures and diagnostic biopsies. To reduce the risk of disease transmission, infection control practices should include identification of the risk of infection, implementation of safety protocols (eg, use of personal protective equipment), proper selection and use of instrumentation, and adequate disinfection and sterilization practices. Silent carriers, risks of iatrogenic infection, and the possibility of inadvertent exposure of healthy patients may carry great liability to public health and hospital stability.

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Anesthetic management in patients suspected of Creutzfeldt-Jakob disease -A case report-

Cited by 7 publications

References 9 publications

A case report of sporadic Creutzfeldt-Jakob disease in an Asian origin coronavirus disease-19 patient: An enigma

A case report of sporadic Creutzfeldt-Jakob disease in an Asian origin coronavirus disease-19 patient: An enigma

Functional Magnetic Resonance Imaging in the Final Stage of Creutzfeldt-Jakob Disease

Special Needs Populations: Perioperative Care of the Patient With Creutzfeldt‐Jakob Disease

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