E-ISSN 1309-4866
Case Report
Focal FDG-PET Hypometabolism as the Sole Initial İmaging Finding in Creutzfeldt Jacob Disease
1 Department of Neurology, Kartal Dr. Lütfi Kırdar Training and Research Hospital, İstanbul, Turkey  
2 Department of Neurology, Near East University School of Medicine, Lefkoşa, Cyprus  
3 Department of Neurology, Hacettepe University School of Medicine, Ankara, Turkey  
Arch Neuropsychiatry ; : -
DOI: 10.5152/npa.2017.19471
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Key Words: Creutzfeldt-Jacob, positron emission tomography, PET, prion, magnetic resonance imaging
Abstract

In the diagnosis of Creutzfeldt-Jacob disease (CJD), laboratory studies such as electroencephalography, cerebrospinal fluid examination and diffusion-weighted  magnetic resonanceimaging (DWIMRI) are valuable. However, these laboratory studies may not show the characteristic findings in the very early stage of the disease. Here, we present a case of CJD who had atypical neurologic presentation initially and had only a focal parietal 2-(18F) fluorodeoxyglucose (FDG) positron emission tomography (PET) hypometabolism as the sole imaging abnormality at the beginning. The patient progressed rapidly and showed typical neurological findings for CJD. The brain MRI was performed two weeks after the FDG-PET study, finally demonstrated increased signal intensity in DWI in caudat nucleus, putamen and cerebral cortex, especially on left parietal region.

 

Imaging methods demonstrating functional alterations in the brain should be obtained in the early period in patients with normal MRI suspected having CJD. Repeating DWI could also be an effective diagnostic approach. 

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