Creutzfeldt-Jakob Disease

Definition

Creutzfeldt-Jakob disease (CJD) is a rare, fatal, degenerative brain disorder characterized by rapidly progressive dementia.

CJD can be categorized into different subtypes:

• Sporadic CJD—also called classical CJD; most common type; usually affects people aged 50 years and older
• Familial CJD—an inherited form of the disease
• Iatrogenic CJD—contracted through medical procedures, such as injections of growth hormone or receipt of corneal transplants or dura mater implants from affected donors
• New variant CJD (vCJD) —caused by eating contaminated beef products, which may cause bovine spongiform encephalopathy (BSE)
  • BSE is commonly known as mad cow disease. vCJD differs from other forms of CJD because it affects younger people and has a longer average time course.

Causes

There has been a lot of scientific research about the cause of CJD. Today, it is generally believed that most noninherited cases are caused by infectious proteins called prions. Prions can transform normal protein molecules into abnormal, disease-causing molecules.

Risk Factors

Factors that can increase your chance of developing CJD include:

• Age: 50-75 years
• Use of cadaveric growth hormone
• Cornea transplants
• Dura mater grafts
• Family members with CJD—Approximately 10%-15% of cases are inherited
• Eating beef products produced by countries with an epidemic of BSE
• Healthcare workers who work with brain tissues
• Blood transfusion from someone with CJD

Symptoms

Initially, there are no symptoms. As CJD progresses, symptoms that may occur include:

• Memory lapses
• Difficulty concentrating
• Impaired judgment
• Difficulty with speech
• Loss of coordination
• Blurred vision
• Behavior and mood changes
• Muscle spasms
• Seizures
• Loss of mental and physical function

Depending on the type of CJD, the disease may last from 3-36 months or longer. It is almost always fatal.

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done.

CJD is a difficult disease to diagnose. There is no single test to detect it. The following tests may be used to help make a diagnosis:

• You may need to have your brain activity recorded. This can be done with electroencephalogram (EEG).
• Images may need to be taken of your brain. This can be done with:
  • Computed tomography (CT) scan
  • Magnetic resonance imaging (MRI) scan
• You may need to have your brain's use of glucose checked. This can be done with a brain positron emission tomography (PET) scan.
• Your bodily fluids may need to be tested. This can be done with: removal of a sample of brain tissue for testing
  • Brain biopsy
  • Blood tests
  • Lumbar puncture

MRI Scan of the Brain

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Treatment

There is no cure for CJD. The aim of treatment is to relieve pain and alleviate symptoms.

Drug therapy may include:

• Opiates to treat pain
• Anticonvulsive drugs to help decrease neuromuscular problems

Prevention

To avoid the new variant form of this condition, it is recommended that you avoid eating beef produced in areas that may have BSE. There are no known ways to prevent other forms of CJD.