Creutzfeldt-Jakob Disease after Dental Procedure Along with the Initial Manifestations of Psychiatric Disorder: A Case Report

Abstract

Introduction: Creutzfeldt-Jakob disease (CJD) as a prion disease is an untreatable type of progressive neurodegenerative encephalopathy. Although no definitive case has been reported yet, here we report a case that given the history, course of symptoms, and recent dental practice, it is highly probable that it was caused by dental procedures.
 Case Report: The patient was a 52-year-old woman who has had memory problems gradually with forgetting the names of family members since 6 weeks prior to the visit and shortly after the dental procedure. She experienced progressive visual hallucinations accompanied by a sharp decline in cognitive, verbal, and motor abilities in just a few weeks. Finally, the diagnosis of Creutzfeldt-Jakob was made for her based on the clinical history and typical brain MRI.
 Discussion: Clinical evidence of this patient, along with positive brain MRI results, indicates the risk of prion transfer through dental procedures. Paying attention to the neurological aspects of psychiatric manifestations and increasing the awareness of dentists about how to deal with and act on the potential dangers of prion transfer is of paramount importance.

Understanding Creutzfeldt-Jakob disease in Iran: a systematic review of case reports

“…The non-specific nature of CJD symptoms increases the risk of misdiagnosis ( Table 3 ). 8 , 12 – 22 Patient-4’s initial suspicion of Chiari malformation 15 and Patient-7’s diagnosis of an acute psychotic episode underscore the challenge in distinguishing CJD from other neurological or psychiatric conditions. Patient-11, 12 initially received antidepressants, further exemplifies the risk of overlooking CJD in the absence of specific diagnostic markers.…”

“…8 , 12 – 22 Patient-4’s initial suspicion of Chiari malformation 15 and Patient-7’s diagnosis of an acute psychotic episode underscore the challenge in distinguishing CJD from other neurological or psychiatric conditions. Patient-11, 12 initially received antidepressants, further exemplifies the risk of overlooking CJD in the absence of specific diagnostic markers. Therefore, the diagnosis of CJD is challenging due to its varied symptoms, which can mimic other neurological or psychiatric conditions.…”

“…Thirteen cases from twelve studies were included to extract information for investigating CJD in Iranian patients (Table 1). 8,[12][13][14][15][16][17][18][19][20][21][22] The mean AE SD age of the 13 cases was 59.38 AE 7.44 years. The regional distribution of CJD cases in Iran, encompassing areas such as Tabriz, Mashhad, Tehran, Rafsanjan and Babol, indicates potential regional factors influencing CJD incidence and diagnosis.…”

“…The varied symptoms of the disease and the absence of specific diagnostic tests lead to delays or incorrect diagnoses (Table 2). 8,[12][13][14][15][16][17][18][19][20][21][22] Diagnosing CJD is difficult because its symptoms can imitate other neurological or mental health disorders. Patients with a final diagnosis of CJD exhibited cognitive impairment, which is consistent with the most common sporadic subtype of CJD.…”

Influence of Multiple Used Implant Drills on Their Cutting Performance and Fracture Resistance

“…This might lead to wear effects on the cutting flutes [23]. Because of the low risk of infection and the excessively high material costs associated with single-use, it is generally standard practice to sterilize the implant drills [43][44][45].…”