Author/Authors :
Nwobi, Onyi Rutgers-Robert Wood Johnson Medical School - Piscataway - NJ, USA , Yegya-Raman, Nikhil Rutgers-Robert Wood Johnson Medical School - Piscataway - NJ, USA , Aziz, Rehan Psychiatry at Rutgers-Robert Wood Johnson Medical School - Piscataway - NJ, USA , Tobia, Anthony Psychiatry at Rutgers-Robert Wood Johnson Medical School - Piscataway - NJ, USA , Schneider, Daniel Neurology at Rutgers-Robert Wood Johnson Medical School - Piscataway - NJ, USA , Leitch, Megan Neurology at Rutgers-Robert Wood Johnson Medical School - Piscataway - NJ, USA
Abstract :
Creutzfeldt-Jakob disease is a rare disorder of the central nervous system. Its initial diagnosis may be obscured by itsvariable presentation. This case report illustrates the complexity of diagnosing this disease early in the clinical course, especiallywhen the initial symptoms may be psychiatric. It offers a brief review of the literature and reinforces a role for consultation psychiatryservices.Methods. PUBMED/MEDLINE was searched using the terms “Creutzfeldt-Jakob disease”, “psychiatric symptoms”,“conversion disorder”, “somatic symptom disorder”, “functional movement disorder”, and “functional neurologic disorder”.Case.The patient was a 64-year-old woman with no prior psychiatric history who was initially diagnosed with conversion disorder andunspecified anxiety disorder but soon thereafter was discovered to have Creutzfeldt-Jakob disease.Discussion. This case highlightsthe central role of psychiatric symptoms in early presentations of Creutzfeldt-Jakob disease. Still, few other cases in the literaturereport functional neurological symptoms as an initial sign. The consultation psychiatrist must remain alert to changing clinicalsymptoms, especially with uncharacteristic disease presentations.
