Publicación Oficial de la Sociedad Ecuatoriana de Neurología, de la Liga Ecuatoriana Contra la Epilepsia y de la Sociedad Iberoamericana de Enfermedad Cerebrovascular

Creutzfeldt-Jakob syndrome

 

Presentación Atípica de la Enfermedad de Creutzfeldt-Jakob. Reporte de Caso en la Patagonia Chilena. Atypical Presentation of Creutzfeldt-Jakob Disease. A Case Report in Chilean Patagonia

Introduction: Creutzfeldt-Jakob disease (CJD) is a fatal neurodegenerative disease. Symptoms include rapidly progressive dementia, myoclonus and motor impairment. In Chile, there is a remarkably high incidence, which together with the lethality of it highlights the importance of early diagnosis.

Case report: A 64-year-old woman presented with vertigo, gait instability, dysarthria and diplopia. Physical examination revealed ataxia, dysmetria and dysdiadochokinesia. Magnetic resonance imaging and electroencephalogram were ordered, with findings suggestive of CJD. Patient’s condition deteriorated rapidly, developing dementia after 3 months and dying in the fourth month.

Discussion and conclusion: CJD variants may present without alteration of cognitive functions and nonspecific prodromes. Diagnosis requires a high index of suspicion, taking as essential tests the nuclear magnetic resonance and the measurement of 14-3-3 protein in cerebrospinal fluid. The increased incidence in Chile may be due to mutations and environmental factors, suggesting the need to thoroughly in vestigate the causes and develop appropriate treatments.

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Encephalitis and rapidly progressive dementia due to probable Prion disease presenting with a non-convulsive status epilepticus. Case report and literature review. Encefalitis y demencia rápidamente progresiva por probable enfermedad priónica que se presenta con un estado epiléptico no convulsivo. Reporte de caso y revisión de la literatura.

Prion diseases are rare and rapidly progressive fatal neurological disorders characterized by abnormal folding of neuronal proteins.

The diagnosis is often challenging and relies on a high clinical suspicion, imagenological findings, electroencephalographic (EEG) patterns and cerebrospinal fluid (CSF) analysis.

We present a case of probable prion disease with an accelerated neurological decline and a non-convulsive status epilepticus (NCSE), which has only been described in a few cases worldwide, and seems to be associated with worse neurological outcomes and shorter survival time.

Clinical manifestations, treatment, and outcomes are shown below.

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