A case of Creutzfeldt-Jakob disease with a mental disorder as the first manifestation
10.3760/cma.j.cn113661-20220522-00126
- VernacularTitle:以精神障碍为首次发病症状的克-雅病1例
- Author:
Yin TIAN
1
;
Xiaoxiao HE
;
Xiaohan HUANG
;
Xiao JI
Author Information
1. 首都医科大学附属北京安定医院急诊科，北京100088
- Publication Type:Journal Article
- Keywords:
Creutzfeldt-Jakob syndrome;
Mental disorders;
Akinetic mutism;
14-3-3 proteins;
Electroencephalography
- From:
Chinese Journal of Psychiatry
2023;56(2):122-125
- CountryChina
- Language:Chinese
-
Abstract:
Creutzfeldt-Jakob disease (CJD), referred to as Creutzfeldt-Jakob disease, is a degenerative disease of the central nervous system caused by prion protein infection. The course of CJD is short, the disease progress is rapid, and the fatality rate of CJD is 100%. The initial symptoms of the disease are complex and diverse, therefore, it could be easily misdiagnosed and mistreated in clinical practice. The patient was a 57-year-old male who presented with mental disorder as the first symptom. He had progressive cognitive decline, and gradually progressed from catatonia to unresponsive arousal. The nervous system examination showed neck stiffness, increased muscle tone, tendon hyperreflexia, limb motor ataxia, ankle clonus, and positive pathological signs on the right side 'of the body'. Auxiliary examination showed positive 14-3-3 protein in cerebrospinal fluid, and EEG showed "periodic three-phase waves"; head MRI DWI showed typical "lace sign" of cerebral cortex. Combined with the clinical characteristics of the patient, according to the WHO diagnostic criteria, the diagnosis is likely to be Creutzfeldt-Jakob disease. The patient has received antidepressant, modified electroconvulsive therapy (MECT) and other treatments in the department of psychiatry, and after being transferred to the neurology department, he symptomatic and supportive treatment related to improving circulation, nourishing nerves, and protecting the brain. However, the clinical symptoms of the patients were progressively worsened, and there was no specific and effective treatment for this disease. This article reviewed the clinical data of patients and relevant literature, hoping to improve the identification of the disease among psychiatric clinicians.
