A Case of Creutzfeldt-Jakob Disease Showing Decreased Cerebral Blood Flow on Tc-99m ECD SPECT at an Early Stage

作者：Suzuki Y^*; Oishi M; Ishihara M; Kamei S

来源：Ceska a Slovenska Neurologie a Neurochirurgie, 2011, 74(2): 211-214.

• Creutzfeldt-Jakob disease
• early stage
• MRI
• SPECT
• cerebral blood flow

This report presents the case of a Japanese man who presented with disturbed position sense in his left leg and later developed ataxia. Tc-99m ECD SPECT showed reduced perfusion in the parieto-temporal regions, especially in the left temporal area, although there were no abnormalities on the first MRI-diffusion-weighted images (DWI). After the first MRI, he developed a disturbance of short-term memory, disorientation, and myoclonus of the left upper extremity, and he could no longer utter words. One month after the first MRI, repeat MRI-DWI showed bilateral abnormalities in the cerebral cortex, putamen, and caudate head, A cerebrospinal fluid (CSF) test revealed that CSF 14-3-3 protein was positive, and the neuron-specific enolase (NSE) level was 300 pg/ml. The prion protein gene showed M/M polymorphism at codon 129. On the basis of his symptoms, clinical course, and laboratory findings, the patient was diagnosed as having probable Creutzfeldt-Jakob disease (CJD). These results suggest that SPECT may be more sensitive than MRI for detecting the abnormalities of sporadic CJD.

• 出版日期2011