医学
磁共振弥散成像
磁共振成像
病理
鉴别诊断
阶段(地层学)
脑电图
病变
放射科
疾病
神经学
生物
精神科
古生物学
作者
Manato Yasuda,Atsuhiko Sugiyama,Hideharu Hokkoku,Tomoki Suichi,Keiichi Ito,Katsuya Satoh,Tetsuyuki Kitamoto,Satoshi Kuwabara
出处
期刊:Neurology
[Ovid Technologies (Wolters Kluwer)]
日期:2022-10-18
卷期号:99 (16): 699-702
被引量:6
标识
DOI:10.1212/wnl.0000000000201221
摘要
Currently, no established biomarkers exist for presymptomatic sporadic Creutzfeldt-Jakob disease (sCJD). The purpose of this study was to raise awareness about sCJD cases showing abnormalities on brain MRI diffusion-weighted imaging (DWI) before symptom onset and demonstrate temporal changes in DWI abnormalities during the preclinical period.We described the clinical presentation including the results of MRI-performed multiple times in the preclinical period-and the diagnostic workup of a middle-aged man with sCJD.MRI of the brain performed 27 months before symptom onset revealed an extremely localized lesion on DWI in the right occipital cortex. Follow-up MRI scans showed propagation of DWI abnormalities along the cortices without the appearance of neurologic symptoms/signs. After symptom onset, the patient's neuropsychiatric condition rapidly deteriorated. Elevated total tau protein levels and positive 14-3-3 protein were observed in the CSF, and periodic synchronous discharges using electroencephalography resulted in the diagnosis of sCJD.CJD should be considered in differential diagnoses when localized DWI signal abnormalities propagate along the cortices over time, even in the absence of typical CJD symptoms. DWI signal abnormalities on brain MRI scans may be highly sensitive diagnostic markers for CJD, even in the preclinical stage.
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