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

Full text of this article

PDF of this article

Email this article to a friend

Respond to this article

Read responses to this article

See related This week in BMJ item

Download to Citation Manager

Search Medline for articles by:

Spencer, M. D || Will, R. G

Alert me when:

New articles cite this article

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

^a Department of Psychiatry, Box 189, Addenbrooke's Hospital, Cambridge CB2 2QQ, ^b National CJD Surveillance Unit, Western General Hospital, Edinburgh EH4 2XU

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

Objective: To describe the early psychiatric and neurologicalfeatures of variant Creutzfeldt-Jakobdisease.
Design: Cohortstudy.
Setting: National surveillance system for Creutzfeldt-Jakob disease in the UnitedKingdom.
Participants: The first 100 cases of variant Creutzfeldt-Jakob disease identified in the UnitedKingdom.
Main outcome measures: The timing and nature of early psychiatricand neurological symptoms in variant Creutzfeldt-Jakobdisease.
Results: The early stages of variant Creutzfeldt-Jakobdisease are dominated by psychiatric symptoms, but neurologicalsymptoms precede psychiatric symptoms in 15% of cases and arepresent in combination with psychiatric symptoms in 22% of casesfrom the onset of disease. Common early psychiatric features includedysphoria, withdrawal, anxiety, insomnia, and loss of interest.No common early neurological features exist, but a significantproportion of patients do exhibit neurological symptoms within4 months of clinical onset, including poor memory, pain, sensorysymptoms, unsteadiness of gait, anddysarthria.
Conclusions: Although the diagnosis of variant Creutzfeldt-Jakobdisease may be impossible in the early stages of the illness, particular combinations of psychiatric and neurological featuresmay allow early diagnosis in an appreciable proportion ofpatients.

What is already known on this topic
The early stages of variant Creutzfeldt-Jakob disease are dominated by psychiatric symptomatology

Some patients have early neurological features that might suggest the presence of an underlying neurological disorder

What this study adds
This study provides a comprehensive description of the evolution of psychiatric and neurological features in variant Creutzfeldt-Jakob disease

An appreciable proportion of patients have early neurological symptoms

A high proportion of patients have a combination of psychiatric and neurological features within four months of clinical onset that suggest the diagnosis of variant Creutzfeldt-Jakob disease

© BMJ 2002

Rapid Responses:

Read all Rapid Responses

Initial cases of variant CJD may have different symptoms from later cases: Thomas H Hughes-Davies; bmj.com, 21 Jun 2002 [Full text]

Home

Help

Search/Archive

Feedback

Table of Contents

Vaccination News Home Page

ALL INFORMATION, DATA, AND MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR GENERAL INFORMATION PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE KNOWLEDGE OR OPINIONS OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED AS PROVIDING MEDICAL OR LEGAL ADVICE. THE DECISION WHETHER OR NOT TO VACCINATE IS AN IMPORTANT AND COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU ALONE, IN CONSULTATION WITH YOUR HEALTH CARE PROVIDER.