brain, spinal cord, and nerve disorders
Creutzfeldt Jakob Disease (CJD)
Diagnosis of Creutzfeldt Jakob Disease
Magnetic resonance imaging Analysis of cerebrospinal fluid (obtained by spinal tap) Electroencephalography Doctors consider Creutzfeldt-Jakob disease in older people when all of the following are present: Mental function is deteriorating quickly. Muscles jerk involuntarily. Their walk is unsteady and staggering. Other dementias have been ruled out by routine testing. Doctors may suspect vCJD in younger people who have typical symptoms and who have eaten processed beef in the United Kingdom or in other countries where mad cow disease has occurred or where beef is imported from the United Kingdom. They may suspect familial CJD when people have relatives with CJD. Diagnosis of Creutzfeldt-Jakob disease may be difficult. Other disorders cause similar symptoms, so doctors check for such disorders, particularly ones that can be treated. A useful test is magnetic resonance imaging (MRI). It can detect characteristic changes in the brain, including some that occur only in people with vCJD. A Spinal Tap (lumbar puncture) may be done to obtain a sample of cerebrospinal fluid, which is tested for prions. This test can detect tiny amounts of prion in cerebrospinal fluid and thus can detect CJD better than other tests. A similar urine test can detect vCJD. Electroencephalography (EEG) is usually done to check for characteristic abnormalities in the electrical activity of the brain, which occur in 70% of people with CJD. However, these changes occur late in the disease and may not be present all the time. Usually, a sample of brain tissue does not need to be examined under a microscope (biopsy) in people while they are alive. However, examination after death (autopsy) is critical because it is the only way to confirm the diagnosis and type of prion disease. 