Sato Aki
Department of Neurology, Niigata City General Hospital.
No Shinkei Geka. 2021 Mar;49(2):407-412. doi: 10.11477/mf.1436204406.
Sporadic Creutzfeldt-Jacob disease(sCJD)is a prion disease presenting with subacute or rapidly progressive dementia with a poor prognosis. Asymmetrical cortical lesions with thalamic involvement are found in sCJD cases, which is similar distribution to status epileptics, but the lesions are not observed in the limbic systems, and they rarely occur in the precentral gyrus. Characteristically, hyperintense abnormal findings are more prominent on DWI than on FLAIR and T2WI. 19.9% of CJD is genetic CJD(gCJD), and CJD with a mutation of codon 180 from valine to isoleucine(V180I)accounts for 40% of gCJD in Japan. Patients with this type of gCJD rarely have a family history because of the low penetration rate. The age of onset is usually later, and its clinical symptoms deteriorate more slowly than sCJD. DWI shows abnormal cortical hyperintense signals(cortical ribboning).
散发性克雅氏病(sCJD)是一种朊病毒病,表现为亚急性或快速进展性痴呆,预后较差。sCJD病例中可见不对称性皮质病变并累及丘脑,其分布与癫痫持续状态相似,但在边缘系统未观察到病变,且很少发生在中央前回。其特征是,弥散加权成像(DWI)上的高信号异常表现比液体衰减反转恢复序列(FLAIR)和T2加权成像(T2WI)上更明显。19.9%的克雅氏病为家族性克雅氏病(gCJD),在日本,密码子180由缬氨酸突变为异亮氨酸(V180I)的gCJD占gCJD的40%。由于外显率低,这类gCJD患者很少有家族史。发病年龄通常较晚,其临床症状比sCJD恶化得更慢。DWI显示皮质高信号异常(皮质带征)。