Volume 26, Number 6—June 2020
Characterization of Sporadic Creutzfeldt-Jakob Disease and History of Neurosurgery to Identify Potential Iatrogenic Cases
|Patient no.||Age at CJD onset, y/sex||Year of neurosurgery; reason||Time from neurosurgery to onset of CJD, y||Initial symptoms||Disease duration, mo†||Codon 129 of PRNP||Lesions on DW-MRI||Pathology findings|
|1||75/M||1977; head trauma||30||Dementia||11||MM||CC, BG||ND|
|2||49/F||1985; subarachnoid hemorrhage||9||Insomnia||28||MM||ND||MM2-T|
|3||75/F||1985; tumor||14||Drowsiness, gait disturbance||6||MM||BG, Th||CJD-MMiK|
|4||63/F||1985; tumor||27||Gait disturbance||19||MM||BG, Th||ND|
|5||64/F||1993; subdural hematoma||10||Visual impairment||21||MM||CC||MM2-C|
*Among the patients with history of neurosurgery, average time (+ SD) from neurosurgery to onset of CJD was 18.0 (+ 9.8) years and average age at neurosurgery was 47.2 (+ 10.2) years. However, among 22 patients with PSWCs on EEG, average time (+ SD) from neurosurgery to onset of CJD was 14.3 (± 9.1) years and average age at neurosurgery was 58.0 (± 12.2) years. We noted no statistically significant differences between patients with and without PSWCs on EEG in relation to time between neurosurgery and onset of CJD or in age at neurosurgery. BG, basal ganglia; CC, cerebral cortex; CJD, Creutzfeldt-Jakob disease; DW-MRI, diffusion weighted images on magnetic resonance imaging; MM, methionine homozygous; MM2-C, MM2-cortical type sporadic CJD; MM2-T, MM2-thalamic type sporadic CJD; ND, not done; PRNP, prion protein gene; Th, thalamus.
†Disease duration is the time between onset of CJD and the appearance of akinetic mutism or death.