Med/Psych Update

Evaluating for conversion disorder: When to suspect Creutzfeldt-Jakob disease

Current Psychiatry. 2010 November;9(11):78-83

References

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4. Stone J, Carson A, Aditya H, et al. The role of physical injury in motor and sensory conversion symptoms: a systematic and narrative review. J Psychosom Res. 2009;66:383-390.

5. National Institute of Neurological Disorders and Stroke Creutzfeldt-Jakob disease fact sheet. Available at: http://www.ninds.nih.gov/disorders/cjd/detail_cjd.htm. Accessed August 7, 2010.

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9. Martindale JL, Geschwind MD, Miller BL. Psychiatric and neuroimaging findings in Creutzfeldt-Jakob disease.Curr Psychiatry Rep. 2003;5:43-46.

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19. Liedorp M, van der Flier WM, Hoogervorst EL, et al. Associations between patterns of EEG abnormalities and diagnosis in a large memory clinic cohort. Dement Geriatr Cogn Disord. 2009;27:18-23.

Table 2

Distinguishing features of Creutzfeldt-Jakob disease

	Sporadic CJD	AD	DLBD	FTD-MND
Time course	Rapid progression (median survival 4 to 5 months)	Insidious onset; progressive decline	Insidious onset; progressive decline	May experience rapid course to death
Age at onset	Age 50 to 70	Incidence increases with age (usual onset age 65 to 85)	Older (age ~80)	Young age at onset
EEG findings	Periodic atypical triphasic waves; GPEDs	Normal or diffuse abnormalities	Rarely atypical triphasic waves	Increased slow activity, decreased fast activity
MRI findings	Restricted diffusion	Generalized atrophy	Generalized atrophy	Frontal atrophy
AD: Alzheimer’s disease; CJD: Creutzfeldt-Jakob disease; DLBD: diffuse Lewy body dementia; EEG: electroencephalography; FTD-MND: frontotemporal dementia with motor neuron disease; GPEDs: generalized periodic epileptiform discharges Source: References 7,8,19

Related Resources

National Institute of Neurological Disorders and Stroke. Creutzfeldt-Jakob disease fact sheet. www.ninds.nih.gov/disorders/cjd/detail_cjd.htm.

Centers for Disease Control and Prevention. About CJD. www.cdc.gov/ncidod/dvrd/cjd.

Drug Brand Names

Chlorpromazine • Thorazine, Largactil

Quinacine • Atabrine

Disclosure

Dr. Gagliardi reports no financial relationship with any company whose products are mentioned in this article or with manufacturers of competing products.