Abstract
BackgroundLate-stage Parkinson’s disease (PD) often presents with neuropsychiatric symptoms such as dementia, psychosis, excessive daytime sleepiness, apathy, depression, and anxiety. However, neuropsychiatric symptoms are the cardinal features of Creutzfeldt–Jakob disease (CJD), raising the possibility that CJD may be an overlooked condition when it accompanies late-stage PD.Case presentationWe describe a female autopsy case of PD with a typical clinical course of 17 years, in which CJD overlapped with PD during the final year of the patient’s life. The patient died aged 85 years. Neuropathological features included widespread Lewy body-related α-synucleinopathy predominantly in the brainstem and limbic system, as well as the typical pathology of methionine/methionine type 1 CJD in the brain.ConclusionsOur case demonstrates the clinicopathological co-occurrence of PD and CJD in a sporadic patient. The possibility of mixed pathology, including prion pathology, should be taken into account when neuropsychiatric symptoms are noted during the disease course of PD.
Highlights
Late-stage Parkinson’s disease (PD) often presents with neuropsychiatric symptoms such as dementia, psychosis, excessive daytime sleepiness, apathy, depression, and anxiety
The possibility of mixed pathology, including prion pathology, should be taken into account when neuropsychiatric symptoms are noted during the disease course of PD
In terms of its pathology, the brain takes on a spongy appearance with abnormal prion protein (PrP) deposition
Summary
Our case demonstrates the clinicopathological co-occurrence of PD and CJD in a sporadic patient.
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