A Challenging Case of Creutzfeldt-Jakob Disease Presenting as Stroke.

Abstract

Introduction: Early recognition of Creutzfeldt-Jakob disease relies on awareness of its clinical variability, particularly in patients with complex medical comorbidities.

Case presentation: A 66-year-old woman presented with generalized weakness, tremor, double vision, and slurred speech. Initial imaging and laboratory studies were unremarkable, except for subtle magnetic resonance imaging findings suggestive of encephalitis. Despite treatment with methylprednisolone, her condition worsened. Repeat magnetic resonance imaging raised suspicion for Creutzfeldt-Jakob disease, which was confirmed by cerebrospinal fluid real-time quaking-induced conversion positivity and elevated total tau protein. She succumbed to the disease within a month.

Discussion: Creutzfeldt-Jakob disease is a rare, rapidly progressive prion disease that is often misdiagnosed due to nonspecific early symptoms. Extensive imaging and laboratory investigations may delay diagnosis, as seen in this case.

Conclusions: This case highlights the diagnostic challenges and rapid progression of Creutzfeldt-Jakob disease, emphasizing the need for early recognition and standardized intervention to improve patient care.