NR ALBQ
AU Spencer,M.D.; Knight,R.S.G.; Will,R.G.
TI First hundred cases of variant Creutzfeldt-Jakob disease: retrospective case note review of early psychiatric and neurological features.
QU British Medical Journal 2002 Jun 22; 324(7352): 1479-82
PT journal article; review; review of reported cases
AB 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.
ZR 8
MH Adolescent; Adult; Age of Onset; Aged; Child; Cohort Studies; Creutzfeldt-Jakob Syndrome/diagnosis/epidemiology/*psychology; Human; Mental Disorders/*etiology; Middle Age; Retrospective Studies; Support, Non-U.S. Gov't; Time Factors
AD Department of Psychiatry, Addenbrooke's Hospital, Cambridge CB2 2QQ, UK. r.g.will@ed.ac.uk
SP englisch
PO England