Sporadic CJD initially diagnosed as functional neurological movement disorder
Gender: Female
A 64-year-old woman presented after approximately two months of worsening right-sided tremulous and jerky movements, numbness, ataxia, headaches and joint pain. During the first week of hospitalization, distractibility, variability and entrainment were interpreted as supporting a functional neurological movement disorder. She rapidly deteriorated; repeat EEG and MRI became abnormal, and brain biopsy confirmed sporadic Creutzfeldt-Jakob disease. The paper gives relative intervals rather than calendar dates. Dashboard dates are therefore estimates reconstructed from those intervals and placed before the manuscript receipt date of 16 January 2017. https://pmc.ncbi.nlm.nih.gov/articles/PMC5434310/
Symptoms
Tremulous/jerky movements of right arm
Intermittent resting tremor of right arm
Intermittent resting tremor of right leg
Right-sided numbness
Right-sided weakness (4/5)
Reduced right facial sensation
Ataxia
Ataxic gait
Headaches
Joint pain
Cognitive impairment (MoCA 22/30)
Impaired delayed recall (0/5)
Difficulty with serial subtraction
Difficulty repeating digits backwards
Expressive aphasia
Marked confusion
Rigid posture
Bilateral upper-limb tremor
Myoclonus
Refusal of food and fluids
Family history
- No family history recorded.
Clinical observations
Functional signs reported
Distractibility
Variability
Entrainment
Distractibility
Variability
Entrainment