van der Horn Harm J, Egbers Peter H, Kuiper Michaël A, Schuiling Wouter J
University Medical Centre Groningen, GN, The Netherlands.
Case Rep Neurol Med. 2013;2013:630141. doi: 10.1155/2013/630141. Epub 2013 Apr 4.
Objective. Several tests are available in the diagnostics of sporadic Creutzfeldt-Jakob disease (sCJD); however, none of these is conclusive. We review the values of these tests, from an intensive care unit (ICU) perspective. Methods. Case report and review of the literature. Results. A 53-year-old woman initially presenting with psychiatric symptoms developed myoclonus and was admitted 1 month later to the ICU with a suspected nonconvulsive status epilepticus and respiratory insufficiency, probably due to extensive antiepileptic drug therapy. Typical MRI and EEG findings and a positive 14-3-3 protein led to the diagnosis of sCJD. All treatments were terminated, and autopsy confirmed sCJD. Conclusions. Clinical signs combined with MRI, EEG, and 14-3-3 and/or tau protein determination might be sufficient to diagnose or exclude sCJD and may therefore prevent the application of unnecessary diagnostic tests.
目的。在散发性克雅氏病（sCJD）的诊断中有多种检测方法；然而，这些方法均无定论。我们从重症监护病房（ICU）的角度回顾这些检测方法的价值。方法。病例报告及文献综述。结果。一名53岁女性最初出现精神症状，随后发展为肌阵挛，1个月后因疑似非惊厥性癫痫持续状态和呼吸功能不全入住ICU，可能是由于广泛的抗癫痫药物治疗所致。典型的MRI和脑电图表现以及14-3-3蛋白检测呈阳性，从而诊断为sCJD。所有治疗均终止，尸检证实为sCJD。结论。临床体征结合MRI、脑电图以及14-3-3和/或tau蛋白检测可能足以诊断或排除sCJD，因此可避免进行不必要的诊断检测。
