Drug-induced Creutzfeldt-Jakob disease-like syndrome: early CSF analysis as useful tool for differential diagnosis. Issue 1 (4th December 2018)

• Record Type: Journal Article
• Authors: Paolini Paoletti, Federico; Di Gregorio, Maria; Calabresi, Paolo; Parnetti, Lucilla
• Is Part Of: BMJ case reports. Volume 11:Issue 1(2018)
• Publication Date: 2018-12-04
• Subjects: variant creutzfeld-jakob disease -- drugs: cns (not psychiatric); Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2018-224314
• Languages: English
• ISSNs: 1757-790X

Abstract

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.