Creutzfeldt-Jakob disease physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Myoclonus, extrapyramidal signs and cerebellar signs are the most common physical findings in CJD.[1]
Physical Examination
Neurologic
- Speech impairment
- Jerky movements (myoclonus)
- Balance and coordination dysfunction (ataxia)
- Gait disturbances
- Rigid posture
- Seizures
Diagnostic Criteria
Criteria for a Probable Diagnosis
Diagnosis of Creutzfeldt Jakob disease is probable if following criteria are fulfilled:
- 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
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
No alternative diagnosis is suspected on routine investigation.[2]
Criteria for a Possible Diagnosis
Diagnosis of Creutzfeldt Jakob disease is possible if following criteria are fulfilled:
- 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
Absence of a positive result for any of the three laboratory tests that would classify a case as probable (see above).
PLUS
Duration of illness is less than two years.
PLUS
No alternative diagnosis is suspected on routine investigation.[2]
References
- ↑ Rabinovici, GD.; Wang, PN.; Levin, J.; Cook, L.; Pravdin, M.; Davis, J.; DeArmond, SJ.; Barbaro, NM.; Martindale, J. (2006). "First symptom in sporadic Creutzfeldt-Jakob disease". Neurology. 66 (2): 286–7. doi:10.1212/01.wnl.0000196440.00297.67. PMID 16434680. Unknown parameter
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