Clinical features may allow early diagnosis of variant CJD

Particular combinations of psychiatric and neurological features could point to a diagnosis of variant Creutzfeldt-Jakob disease early in the course of the disease in some patients. Spencer and colleagues (p 1479) analysed the case notes of the first 100 patients diagnosed with variant Creutzfeldt-Jakob disease in the UK to identify the early psychiatric and neurological features. Psychiatric symptoms such as dysphoria, withdrawal, and anxiety predominate in the early stages, but neurological symptoms precede them in 15% of cases and are present in combination with them in 22%. By four months from clinical onset many patients have a combination of symptoms that suggests the diagnosis.

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