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Unusual presentation of more common disease/injury
CASE REPORT
Drug-induced Creutzfeldt-Jakob disease-like syndrome: early CSF analysis as useful tool for differential diagnosis
  1. Federico Paolini Paoletti1,
  2. Maria Di Gregorio1,
  3. Paolo Calabresi1 and
  4. Lucilla Parnetti2
  1. 1 Section of Neurology, Department of Medicine, Universita degli Studi di Perugia, Perugia, Italy
  2. 2 Department of Medicine, Section of Neurology - Centre for Memory Disturbances, Lab of Clinical Neurochemistry, Perugia, Italy
  1. Correspondence to Professor Lucilla Parnetti, lucilla.parnetti{at}unipg.it

Abstract

We report the case of a 78-year-old man who showed a subacute onset of severe cognitive impairment, ataxia, tremor, stimulus sensitive myoclonus and hypophonia. Since a few weeks, he received a treatment with a combination of tricyclic antidepressants for mood disorder. The clinical picture mimicked Creutzfeldt-Jakob disease (CJD), but we could rule out this diagnosis by means of cerebrospinal fluid (CSF) analysis, which showed normal level of tau protein and Aβ1-42, being also negative for CSF 14-3-3 protein. A complete clinical recovery was observed after the discontinuation of antidepressants. So far, some cases of drug-induced CJD-like syndrome have been described. In our experience, early CSF analysis shows high diagnostic usefulness in order to exclude CJD.

  • variant creutzfeld-jakob disease
  • drugs: cns (not psychiatric)

https://doi.org/10.1136/bcr-2018-224314

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    Footnotes

    • Contributors FPP: study concept and design, acquisition of data, analysis and interpretation of data. MDG: study concept and design, acquisition of data, analysis and interpretation of data. PC: study concept and design, acquisition of data, analysis and interpretation of data. LP: study concept and design, acquisition of data, analysis and interpretation of data, study supervision, critical revision of manuscript for intellectual content.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.