Creutzfeldt-Jakob disease presented with dizziness, weakness and neuropsychiatric symptoms: 2 Case Reports

Abstract

Creutzfeldt-Jakob disease (CJD) is among very rare, progressive, untreatable, neurodegenerative prion diseases. While the incidence is reported as 1/1000000 years in European countries, sporadic cases are rarely presented in Turkey. Clinical findings are in the form of rapid progressive dementia, myoclonus, cerebellar, pyramidal and extra pyramidal symptoms. Definitive diagnosis is established by histopathological examination. Our case is a 64-year-old male and 70-year-old female patients admitted with dizziness emerged as sub-acute weakness, nausea, vomiting, insomnia, imbalance and additional neuropsychiatric complaints. Focal activity slowness and common periodic sharp wave activities were observed in EEG. CJD was considered because bilateral symmetrical diffusion limitation was observed at both sides in the basal ganglia level in cranial diffusion MRI's and 14-3-3 protein was resulted as positive in CSF examinations. CJD, which is a very rare disease in patients presenting with progressive neuropsychiatric symptoms and seizure, is one of the diagnosis to be considered and we wanted to emphasize that there is no treatment for it and preventive measures should be taken.

Untitled

“…Differential diagnosis of patients should be conducted properly. Temporal arthritis, HIV, Legionella infections and slow virus infections may be mistaken for viral encephalitis, particularly in cases involving stroke and optic nerves [5,6,7]. At first, aneurysm operation, ptosis, and seizure in the medical history of our patient suggested a new cerebrovascular attack.…”

A case of Creutzfeldt-Jakob disease that started with psychiatric symptoms

“…Although definitive diagnosis is made from brain biopsy, this is not always an easy method to apply (1,11,12).…”

“…Following the onset of symptoms, mean life expectancy is up to 1 year. In the early stages of CJD, depressive symptoms such as fatigue, apathy, withdrawal, sleep and eating disorders and personality changes may be seen in approximately 1 in 3 patients (1)(2)(3)(4).…”