Creutzfeldt-Jakob disease masked by head trauma and features of Wilson's disease

Alessandra Scontrini, Carlo Di Bonaventura, Marco Fiorelli, Dorina Tiple, Elisa Colaizzo, Anna Ladogana, Piero Parchi, Maurizio Pocchiari

Research output: Contribution to journalArticlepeer-review

Abstract

Creutzfeldt-Jakob disease (CJD) is a fatal neurodegenerative disorder typically characterized by progressive dementia associated with myoclonus, cerebellar and other focal neurological signs. Electroencephalogram, brain MRI and cerebrospinal fluid (CSF) analyses are helpful diagnostic tools, but diagnosis in patients with atypical presenting neurological signs is often difficult to make. A 55-year-old woman developed disorientation, drowsiness and focal motor signs after a traumatic brain injury due to an accidental fall. In two weeks, her symptoms worsened in spite of a brain MRI showed an improvement of traumatic lesions, but the presence of bilateral hyperintensity in the basal nuclei was suggestive of a metabolic or prion encephalopathy. The high 24-h urinary copper level and reduction of ceruloplasmin initially supported the diagnosis of Wilson's disease, but the absence of Kayser-Fleischer rings, and the positivity of 14-3-3 protein test and elevated tau concentrations in the CSF oriented toward a diagnosis of CJD. She died 5 months after the onset, and the postmortem examination of the brain revealed immunochemical features of CJD. This case exemplifies the difficulty of a timely diagnosis when rapid progressive dementia is masked by concomitant factors (i.e., head trauma) and neurological signs are associated with unclear laboratory findings.

Original languageEnglish
Pages (from-to)312-314
Number of pages3
JournalInternational Journal of Neuroscience
Volume125
Issue number4
DOIs
Publication statusPublished - Jun 1 2015

Keywords

  • Creutzfeldt-Jakob disease
  • Head injury
  • Neurodegenerative disorders
  • Wilson's disease

ASJC Scopus subject areas

  • Neuroscience(all)

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