Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-25T16:24:01.985Z Has data issue: false hasContentIssue false
  • English
  • Français

Psychiatric features of new variant Creutzfeldt-Jakob disease

Published online by Cambridge University Press:  02 January 2018

R. G. Will ,
G. Stewart ,
M. Zeidler ,
M. A. Macleod  and
R. S. G. Knight
R. G. Will*
Affiliation:
University of Edinburgh and Director of National CJD Surveillance Unit, Western General Hospital Edinburgh EH4 2XU
G. Stewart
Affiliation:
National CJD Surveillance Unit
M. Zeidler
Affiliation:
National CJD Surveillance Unit
M. A. Macleod
Affiliation:
National CJD Surveillance Unit
R. S. G. Knight
Affiliation:
National CJD Surveillance Unit and Western General Hospital Edinburgh
*
∗Correspondence
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Aims and method

New variant Creutzfeldt–Jakob disease is a novel prion disease of humans that may be causally linked to bovine spongiform encephalopathy. Psychiatric symptoms occur in the early stages of the illness and may be difficult to distinguish from the symptoms of more common psychiatric disorders. Cases of new variant Creutzfeldt–Jakob disease are identified through the national surveillance system. Information on psychiatric features has been obtained by review of case notes and, in the majority of cases, by interview of relatives by a member of the surveillance staff.

Results

Thirty-five cases of new variant Creutzfeldt–Jakob disease have been identified in the UK and detailed information on the clinical features and investigations is currently available in 33 of these cases. All but one of the cases exhibited prominent early psychiatric symptomatology, but the diagnosis of an underlying neurological disease was not possible in the majority of cases until the development of neurological symptoms and signs. Early indications of an underlying neurological disorder included cognitive impairment, persistent sensory symptoms or limb pain and, in a minority, gait imbalance, dysarthria or visual symptoms. Limited evidence suggests that investigations such as electroencephalogram or brain imaging are unlikely to provde useful diagnostic information during the ‘psychiatric’ phase of the illness.

Clinical implications

The early recognition of an underlying neurological disorder may be impossible in the early psychiatric phase of new variant Creutzfeldt–Jakob disease, but the suspicion of this diagnosis may be raised by the occurrence of associated neurological symptoms. The development of early diagnostic markers is an important objective.

Type
Original papers
Information
Psychiatric Bulletin , Volume 23 , Issue 5 , May 1999 , pp. 264 - 267
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © 1999 The Royal College of Psychiatrists

References

Bruce, M. E., Will, R. G., Ironside, J. W., et al (1997) Transmissions to mice indicate that ‘new variant’ CJD is caused by the BSE agent. Nature, 389, 498 501.CrossRefGoogle ScholarPubMed
Will, R. G., Ironside, J. W., Zeidler, M., et al (1996) A new variant of Creutzfeldt–Jakob disease in the UK. Lancet, 347, 921 925.Google Scholar
Zeidler, M., Stewart, G. E., Barraclough, C. R., et al (1997a) New variant Creutzfeldt–Jakob disease: neurological features and diagnostic tests. Lancet, 350, 903 907.CrossRefGoogle ScholarPubMed
Zeidler, M., Johnstone, E. C., Bamber, R. W. K., et al (1997b) New variant Creutzfeldt–Jakob disease: psychiatric features. Lancet, 350, 908 910.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.