TY - JOUR TT - A Difficult Diagnosis in Emergency Department: Creutzfeldt–Jakob Disease AU - Güler, Sertaç AU - Aytar, Halit AU - Genç, Sinan AU - Ramadan, Hayri PY - 2015 DA - July JF - Journal of Emergency Medicine Case Reports PB - Acil Tıp Uzmanları Derneği WT - DergiPark SN - 2149-9934 SP - 49 EP - 51 VL - 6 IS - 3 KW - Creutzfeldt-Jakob hastalığı KW - prion hastalıkları KW - demans KW - acil tıp (MeSH Database) N2 - Introduction: Prion diseases are a group of diseases that affect the human brain tissue and cause characteristic spongiform changes. Creutzfeldt-Jakob Disease (CJD) is the most common type of this group of diseases. The diagnosis of CJD is very difficult particularly in emergency department (ED) settings and is mainly based on the exclusion of the other causes of ongoing mental status changes.Case Report: We present the case of a 77-year-old female as a sporadic CJD patient who was consulted with the preliminary diagnosis of CJD in ED. The patient was brought to ED with complaints of being unable to get out of bed and urinary and fecal incontinence. Remarkable physical findings included poor general condition, the lack of verbal response, oromandibular dystonia, eye opening and flexor responses of upper extremities to painful stimuli, and choreoathetosis. All findings including progressive neurological symptoms, brain magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) analysis, and electroencephalography (EEG) were considered together, and the patient was diagnosed with CJD.Conclusion: Even if an ED physician could not diagnose CJD in first hand, he/she should keep the level of additional imaging (MRI, CSF analysis, and EEG) and consultation threshold low, particularly in patients with ongoing mental status changes, jerking movements, and dementia CR - Puoti G, Bizzi A, Forloni G, Safar JG, Tagliavini F, Gambetti P. Sporadic human prion diseases: molecular insights and diagnosis. Lancet Neurol 2012; 11: 618-28. [CrossRef] CR - Ladogana A, Puopolo M, Croes EA, Budka H, Jarius C, Collins S, et al. Mortality from Creutzfeldt-Jakob disease and related disorders in Europe, Australia, and Canada. Neurology 2005; 64: 1586-91. [CrossRef] CR - Masters CL, Harris JO, Gajdusek DC, Gibbs CJ Jr, Bernoulli C, Asher DM. CreutzfeldtJakob disease: patterns of worldwide occurrence and the significance of familial and sporadic clustering. Ann Neurol 1979; 5: 177-88. [CrossRef] CR - Haywood AM. Transmissible spongiform encephalopathies. N Engl J Med 1997; 337: 1821-8. [CrossRef] CR - Heinemann U, Krasnianski A, Meissner B, Varges D, Kallenberg K, SchulzSchaeffer WJ, et al. Creutzfeldt-Jakob disease in Germany: a prospective 12-year surveillance. Brain 2007; 130: 1350-9. [CrossRef] CR - Pocchiari M, Puopolo M, Croes EA, Budka H, Gelpi E, Collins S, et al. Predictors of survival in sporadic Creutzfeldt-Jakob disease and other human transmissible spongiform encephalopathies. Brain 2004; 127: 2348-59. [CrossRef] CR - Clendenin J, Lall M. Creutzfeldt-Jacob Disease: An Emergency Department Presentation. American Journal of Emergency Medicine (2014). [CrossRef] CR - Wientjens DP, Davanipour Z, Hofman A, Kondo K, Matthews WB, Will RG. Risk factors for Creutzfeldt-Jakob disease: a reanalysis of case-control studies. Neurology 1996; 46: 1287-91. [CrossRef] CR - Collins S, Law MG, Fletcher A, Boyd A, Kaldor J, Masters CL. Surgical treatment and risk of sporadic Creutzfeldt-Jakob disease: a case-control study. Lancet 1999; 353: 693-7. [CrossRef] CR - CDC's Diagnostic Criteria for Creutzfeldt-Jakob Disease (CJD), 2010 http://www.cdc.gov/ncidod/dvrd/cjd/diagnostic_criteria.html (Accessed on October 27, 2014). UR - https://dergipark.org.tr/en/pub/jemcr/issue//535975 L1 - https://dergipark.org.tr/en/download/article-file/663984 ER -