Abstract
Creutzfeldt-Jakob Disease (CJD) is a rare rapidly progressive neurodegenerative disease. The diagnosis of CJD is based on magnetic resonance imaging (MRI) findings, electro-encephalography (EEG), or 14-3-3 protein detection. We report a case of a previously-healthy 72 years old woman, with evidence of coronavirus disease 2019 (COVID-19), who complained of behavioral changes and rapidly progressive dementia. While hospitalization, she didn't have orientation to time and place and repeated an irrelevant sentence in response to questions. Also, anomia and impaired comprehension was observed. Myoclonic jerks, abnormal signal intensity at bilateral parieto-occipital cortices in MRI, periodic sharp wave complexes in EEG, and increased lactate dehydrogenase in cerebrospinal fluid (CSF), highly recommended CJD for her. This is the second case of CJD after COVID-19 during this pandemic, which can be an alarm to clinicians about the silent impact of COVID-19 on the central nervous system.
Highlights
In the first months of 2020, the outbreak of a novel coronavirus, called Respiratory severe acute syndrome coronavirus 2 (SARS-CoV-2), impressed all the world society
We report a case of a previously-healthy 72 year-old woman, with evidence of coronavirus disease 2019 (COVID-19), who complained of behavioral changes and rapidly progressive dementia
Abnormal signal intensity at bilateral parieto-occipital cortices in magnetic resonance imaging (MRI), periodic sharp wave complexes in EEG, and increased lactate dehydrogenase in cerebrospinal fluid (CSF) highly recommended Creutzfeldt-Jakob disease (CJD) as the diagnosis. This is the second case of CJD after COVID-19 during this pandemic, which can be an alarm to clinicians about the silent impact of COVID-19 on the central nervous system
Summary
In the first months of 2020, the outbreak of a novel coronavirus, called Respiratory severe acute syndrome coronavirus 2 (SARS-CoV-2), impressed all the world society. COVID-19’s possible effect on accelerating neurodegeneration and Creutzfeldt-Jakob disease (CJD) was reported in the United States for the first time in a previously healthy man, whose symptoms started with confusion and delirium, progressed to paucity of speech over two weeks, and died after 2 months.[14] CJD is a rare rapidly progressive neurodegenerative disease and the commonest form of human prion disease caused by the accumulation of abnormal proteins in the neurons of central nervous system.[15] Usually, CJD appears in patients with 55-75 years old, and in about 90% of cases, leads to death over one year.[16] Myoclonus is the characteristic feature of CJD, but it can be presented with unstable gait, personality and behavioral changes, failing memory, and unstable gait, too.
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