Table of Contents
Washington University Experience | PRION DISEASES | Prion Diseases | 19A0 Case 19 History
Case 19 History ---- The patient was a 61 year old man with a suspected traumatic brain injury in November of 2012, persisting short term memory loss and dizziness, and clinical/radiological features suspicious for CJD. In November 2012, he struck his head but did not lose consciousness. After this event, he felt dizzy for the day, without other neurological complaints. The next day he had some mild weakness; dizziness may have persisted to some extent. In January 2013, his dizziness became worse and he began to have memory problems. He felt unsteady on his feet, developed some ataxic symptoms, experienced approximately 10 subsequent falls, and required a cane to walk by April 2013. He also developed some blurry vision or double vision, worse when looking into light. By June 2013, in addition to his other neurological symptoms, he had developed hoarse speech, vivid dreams, speaking while sleeping, short term memory loss, and confusion. CT) of the head, read as normal at an outside hospital (March 2013), and magnetic resonance imaging (MRI), read as mild atrophy with mild periventricular white matter changes (June 2013). In June 2013 he was admitted to BJH for workup of his ataxia and short term memory loss. On the day of admission, MRI showed diffusion restriction with associated T2 and FLAIR abnormalities in the caudate, lentiform nuclei, and thalami; these findings raised concern for CJD and prompted additional testing to evaluate for CJD and its mimics. Many tests were performed but tau and 14-3-3 proteins (NPDPSC) were consistent with CJD. The patient died in August 2013 10 months after onset.
