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{{‪Creutzfeldt-Jakob disease‬}}
{{CMG}}{{AE}}{{MMJ}}


{{‪Creutzfeldt-Jakob disease‬}}
{{CMG}}
==Overview==
==Overview==
[[Myoclonus]], [[Neurological examination|extrapyramidal signs]] and [[Neurological examination|cerebellar signs]] are the most common physical findings in CJD.<ref name="Rabinovici-2006">{{Cite journal  | last1 = Rabinovici | first1 = GD. | last2 = Wang | first2 = PN. | last3 = Levin | first3 = J. | last4 = Cook | first4 = L. | last5 = Pravdin | first5 = M. | last6 = Davis | first6 = J. | last7 = DeArmond | first7 = SJ. | last8 = Barbaro | first8 = NM. | last9 = Martindale | first9 = J. | title = First symptom in sporadic Creutzfeldt-Jakob disease. | journal = Neurology | volume = 66 | issue = 2 | pages = 286-7 | month = Jan | year = 2006 | doi = 10.1212/01.wnl.0000196440.00297.67 | PMID = 16434680 }}</ref>


==Physical Examination==
==Physical Examination==
===Neurologic===
===Appearance of the Patient===
*Patients with Creutzfeldt-Jakob disease usually appear confused.
 
===Vital Signs===
* Vital Signs of patients with Creutzfeldt-Jakob disease are usually normal.
 
===Skin===
* Skin examination of patients with Creutzfeldt-Jakob disease is usually normal.
===HEENT===
* HEENT examination of patients with Creutzfeldt-Jakob disease is usually normal.
===Neck===
* Neck examination of patients with Creutzfeldt-Jakob disease is usually normal.
===Lungs===
* Pulmonary examination of patients with Creutzfeldt-Jakob disease is usually normal.
===Heart===
* Cardiovascular examination of patients with Creutzfeldt-Jakob disease is usually normal.
===Abdomen===
* Abdominal examination of patients with Creutzfeldt-Jakob disease is usually normal.
===Back===
* Back examination of patients with Creutzfeldt-Jakob disease is usually normal.
===Genitourinary===
* Genitourinary examination of patients with Creutzfeldt-Jakob disease is usually normal.
===Neuromuscular===
Physical examination of patients with Creutzfeldt-Jakob disease is usually remarkable for:<ref name="pmid22394291">{{cite journal |vauthors=Head MW, Ironside JW |title=Review: Creutzfeldt-Jakob disease: prion protein type, disease phenotype and agent strain |journal=Neuropathol. Appl. Neurobiol. |volume=38 |issue=4 |pages=296–310 |date=June 2012 |pmid=22394291 |doi=10.1111/j.1365-2990.2012.01265.x |url=}}</ref><ref name="pmid5710312">{{cite journal |vauthors=Argelander H |title=[The psychoanalytic dialogue] |language=German |journal=Psyche (Stuttg) |volume=22 |issue=5 |pages=325–39 |date=May 1968 |pmid=5710312 |doi= |url=}}</ref><ref name="pmid22411235">{{cite journal |vauthors=Sikorska B, Knight R, Ironside JW, Liberski PP |title=Creutzfeldt-Jakob disease |journal=Adv. Exp. Med. Biol. |volume=724 |issue= |pages=76–90 |date=2012 |pmid=22411235 |doi=10.1007/978-1-4614-0653-2_6 |url=}}</ref><ref name="pmid29939637">{{cite journal |vauthors=Sitammagari KK, Masood W |title= |journal= |volume= |issue= |pages= |date= |pmid=29939637 |doi= |url=}}</ref><ref name="pmid3689509">{{cite journal |vauthors=Helton AS, Snodgrass FG |title=Battering during pregnancy: intervention strategies |journal=Birth |volume=14 |issue=3 |pages=142–7 |date=September 1987 |pmid=3689509 |doi= |url=}}</ref>
* [[Speech communication|Speech]] impairment
* [[Speech communication|Speech]] impairment
* Jerky movements ([[myoclonus]])
* [[Myoclonus]]
* Balance and coordination dysfunction ([[ataxia]])
* [[Ataxia]]
* [[gait (human)|Gait]] disturbances
* [[gait (human)|Gait]] disturbances
* [[posture|Rigid posture]]
* [[posture|Rigid posture]]
* [[Seizures]]
* [[Dysarthria]]
===Diagnostic Criteria===
* [[Myoclonus]]
Diagnosis of Creutzfeldt Jakob disease is '''probable''' if following criteria are fulfilled:
 
:* Rapidly progressive dementia plus at least any 2 of the following features
* Visual changes leading to [[cortical blindness]]
::* Myoclonus
* [[Akinetic mutism]] in the last stages of the disease
::* Visual or cerebellar signs
* [[Chorea]]
::* Pyramidal and/or extrapyramidal signs
* [[Peripheral neuropathy]]
::* Akinetic mutism
* [[Altered mental status]]
PLUS<br>
[[Myoclonus]] is the most common sign in patients Creutzfeldt-Jakob disease.
Positive result on one of the following laboratory tests:
* Typical [[EEG]] (periodic sharp wave complexes) during an illness of any duration and/or
* A positive 14-3-3 [[cerebrospinal fluid]] (CSF) assay in patients with a disease duration of less than 2 years and/or
* Magnetic resonance imaging (MRI): high signal abnormalities in [[caudate nucleus]] and/or [[putamen]] on diffusion-weighted imaging (DWI) or fluid attenuated inversion recovery (FLAIR).
PLUS<br>
No alternative diagnosis is suspected on routine investigation.<ref name="www.cdc.gov">{{Cite web  | last =  | first =  | title = http://www.cdc.gov/ncidod/dvrd/cjd/diagnostic_criteria.html | url = http://www.cdc.gov/ncidod/dvrd/cjd/diagnostic_criteria.html | publisher =  | date =  | accessdate = 17 February 2014 }}</ref>


Diagnosis of Creutzfeldt Jakob disease is '''possible''' if following criteria are fulfilled:
Patient is usually disoriented to persons, place, and time.
:* Rapidly progressive dementia plus at least any 2 of the following features
::* Myoclonus
::* Visual or cerebellar signs
::* Pyramidal and/or extrapyramidal signs
::* Akinetic mutism
PLUS<br>
Absence of a positive result for any of the three laboratory tests that would classify a case as probable (see above).
PLUS<br>
Duration of illness is less than two years.
PLUS<br>
No alternative diagnosis is suspected on routine investigation.<ref name="www.cdc.gov">{{Cite web  | last =  | first =  | title = http://www.cdc.gov/ncidod/dvrd/cjd/diagnostic_criteria.html | url = http://www.cdc.gov/ncidod/dvrd/cjd/diagnostic_criteria.html | publisher =  | date =  | accessdate = 17 February 2014 }}</ref>


===Extremities===
* Extremities examination of patients with Creutzfeldt-Jakob disease is usually normal.
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
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Latest revision as of 16:21, 24 October 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]

Overview

Physical Examination

Appearance of the Patient

  • Patients with Creutzfeldt-Jakob disease usually appear confused.

Vital Signs

  • Vital Signs of patients with Creutzfeldt-Jakob disease are usually normal.

Skin

  • Skin examination of patients with Creutzfeldt-Jakob disease is usually normal.

HEENT

  • HEENT examination of patients with Creutzfeldt-Jakob disease is usually normal.

Neck

  • Neck examination of patients with Creutzfeldt-Jakob disease is usually normal.

Lungs

  • Pulmonary examination of patients with Creutzfeldt-Jakob disease is usually normal.

Heart

  • Cardiovascular examination of patients with Creutzfeldt-Jakob disease is usually normal.

Abdomen

  • Abdominal examination of patients with Creutzfeldt-Jakob disease is usually normal.

Back

  • Back examination of patients with Creutzfeldt-Jakob disease is usually normal.

Genitourinary

  • Genitourinary examination of patients with Creutzfeldt-Jakob disease is usually normal.

Neuromuscular

Physical examination of patients with Creutzfeldt-Jakob disease is usually remarkable for:[1][2][3][4][5]

Myoclonus is the most common sign in patients Creutzfeldt-Jakob disease.

Patient is usually disoriented to persons, place, and time.

Extremities

  • Extremities examination of patients with Creutzfeldt-Jakob disease is usually normal.

References

  1. ↑ Head MW, Ironside JW (June 2012). "Review: Creutzfeldt-Jakob disease: prion protein type, disease phenotype and agent strain". Neuropathol. Appl. Neurobiol. 38 (4): 296–310. doi:10.1111/j.1365-2990.2012.01265.x. PMID 22394291.
  2. ↑ Argelander H (May 1968). "[The psychoanalytic dialogue]". Psyche (Stuttg) (in German). 22 (5): 325–39. PMID 5710312.
  3. ↑ Sikorska B, Knight R, Ironside JW, Liberski PP (2012). "Creutzfeldt-Jakob disease". Adv. Exp. Med. Biol. 724: 76–90. doi:10.1007/978-1-4614-0653-2_6. PMID 22411235.
  4. ↑ Sitammagari KK, Masood W. PMID 29939637. Missing or empty |title= (help)
  5. ↑ Helton AS, Snodgrass FG (September 1987). "Battering during pregnancy: intervention strategies". Birth. 14 (3): 142–7. PMID 3689509.

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