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http://bmj.com/cgi/content/abstract/324/7352/1479

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Collections under which this article appears: variant Creutzfeld-Jakob Disease Other Neurology Other Psychiatry

BMJ 2002;324:1479-1482 ( 22 June )
 

Papers

First hundred cases of variant Creutzfeldt-Jakob disease: retrospective case note review of early psychiatric and neurological features

Michael D Spencer, research fellow, ^a Richard S G Knight, consultant neurologist, ^b Robert G Will, professor of clinical neurology. ^b

Correspondence to: Robert G Will r.g.will@ed.ac.uk

Objective: To describe the early psychiatric and neurological features of variant Creutzfeldt-Jakob disease.
Design: Cohort study.
Setting: National surveillance system for Creutzfeldt-Jakob disease in the United Kingdom.
Participants: The first 100 cases of variant Creutzfeldt-Jakob disease identified in the United Kingdom.
Main outcome measures: The timing and nature of early psychiatric and neurological symptoms in variant Creutzfeldt-Jakob disease.
Results: The early stages of variant Creutzfeldt-Jakob disease are dominated by psychiatric symptoms, but neurological symptoms precede psychiatric symptoms in 15% of cases and are present in combination with psychiatric symptoms in 22% of cases from the onset of disease. Common early psychiatric features include dysphoria, withdrawal, anxiety, insomnia, and loss of interest. No common early neurological features exist, but a significant proportion of patients do exhibit neurological symptoms within 4 months of clinical onset, including poor memory, pain, sensory symptoms, unsteadiness of gait, and dysarthria.
Conclusions: Although the diagnosis of variant Creutzfeldt-Jakob disease may be impossible in the early stages of the illness, particular combinations of psychiatric and neurological features may allow early diagnosis in an appreciable proportion of patients.

 

© BMJ 2002

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