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According to the WHO diagnostic criteria,1 sporadic Creutzfeldt−Jakob disease (sCJD) is diagnosed by characteristic electroencephalographic (EEG) findings, the presence of 14-3-3 protein in the cerebrospinal fluid (CSF) and appropriate clinical symptoms.1
Recent studies have made progress towards establishing a diagnosis of sCJD from the combination of diffusion-weighed MR images and 14-3-3 protein detected in the CSF; however, the earliest markers of this disease are not known.
We evaluated a patient with sCJD who exhibited abnormal high-intensity signals on diffusion-weighed MR imaging (DWI) during an incidental medical check-up that included an MRI. Here, we report the chronological changes in clinical and MRI findings beginning 2 months before disease onset to end-stage sCJD.
A 68-year-old male requested neurological and MRI examinations from his local physician in October, 2005, because his sister had previously died from subarachnoid haemorrhage several years earlier. While DWI of the cerebrum demonstrated a predominantly right-sided high signal intensity in the cortex from the temporal to occipital lobes (figure 1), we did not detect any abnormalities on T2-weighted or FLAIR images. His cognitive function (MMSE 30/30) and neurological findings were normal. In November 2005, repeat MRI demonstrated a slight increase in abnormal findings. We tested …
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