Sporadic Creutzfeldt-Jakob disease (sCJD) typically presents with cognitive impairment, ataxia, visual disturbances, pyramidal and extrapyramidal signs, and myoclonus. Neuropathological involvement predominantly affects the cerebrum; however, spinal cord involvement is rare. A 77-year-old man initially presented with numbness in the left lower limb, followed several months later by progressive lower limb paralysis and urinary dysfunction. Spinal magnetic resonance imaging (MRI) revealed spinal cord lesions, and he was admitted to a local hospital with suspected spinal cord disease. During hospitalization, his level of consciousness deteriorated, prompting transfer to our institution. Cerebrospinal fluid analysis demonstrated an elevated IgG index, making differentiation from autoimmune encephalitis challenging. However, characteristic MRI and electroencephalographic findings supported a final diagnosis of sCJD. His condition rapidly worsened, and he died approximately one month after the onset of impaired consciousness. We report a rare case of sCJD with spinal cord involvement. The presence of spinal cord lesions may be associated with a poor prognosis and warrants clinical attention.
Akanuma et al. (Thu,) studied this question.
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