Summary
Definition
History and exam
Key diagnostic factors
- trastorno cognitivo
- ataxia de la marcha y/o de los miembros
- mioclono
- parkinsonismo
- síntomas psiquiátricos
- cambios en la visión
- edad cercana a los 30 años o que va desde mediados a finales de los 60 años
- insomnio, disautonomía
- antecedentes familiares positivos
- síntomas constitucionales o inespecíficos
Other diagnostic factors
- síntomas sensoriales dolorosos
- trastorno del movimiento
Risk factors
- predisposición genética
- instrumentos quirúrgicos contaminados por priones
- transfusión de sangre o hemoderivados (enfermedad de Creutzfeldt-Jakob variante)
- consumo de carne vacuna del Reino Unido desde 1980 hasta 1996
- consumo de carne vacuna de los Estados Unidos
- caza de ciervo, uapití y alce en regiones endémicas de los Estados Unidos y Canadá
- uso de la hormona de crecimiento humana
Diagnostic investigations
1st investigations to order
- IRM cerebral
- electroencefalograma (EEG)
Investigations to consider
- conversión inducida por temblores (QuIC)
- biomarcadores en el LCR
- pruebas genéticas en el gen de la proteína priónica
- biopsia (cerebro, amígdala)
Treatment algorithm
todos los pacientes
Contributors
Authors
Valerie Sim, MD, FRCPC
Associate Professor
Department of Medicine
Division of Neurology
Centre for Prions and Protein Folding Diseases
University of Alberta
Edmonton
Alberta
Canada
Disclosures
VS is principal and co-investigator on several research grants through the University of Alberta, to study prion disease and related neurodegenerative diseases. VS has one patent approved for the development of IgE-based prion therapy. VS is currently a site lead for the Ionis PrProfile trial. VS has been invited to give an educational session on prion disease at the American Academy of Neurology meeting in 2024.
Acknowledgements
Dr Valerie Sim would like to gratefully acknowledge Dr Michael D. Geschwind, Dr Amy Kuo, and Dr R. Ronald Finley, the previous contributors to this topic. MDG participates in the speakers' bureau for Pfizer, Forest, and Novartis; is consultant for MedaCorp, Gerson-Lehman Group, and Clinical Advisors Incorporated; and is an author of a number of references cited in this topic. RRF participates in the speakers' bureau for Pfizer, Forest, and Novartis. AK declares that she has no competing interests.
Peer reviewers
Ali Hassoun, MD, FACP, FIDSA, AAHIVS
Infectious Disease Specialist
Alabama Infectious Diseases Center
Huntsville
AL
Disclosures
AH declares that he has no competing interests.
Robert A. Larsen, MD
Associate Professor of Medicine
University of Southern California
Keck School of Medicine
Los Angeles
CA
Disclosures
RAL declares that he has no competing interests.
William A. Petri, Jr., MD, PhD, FACP
Chief and Professor of Medicine
Division of Infectious Diseases and International Health
University of Virginia Health System
Charlottesville
VA
Disclosures
WAP declares that he has no competing interests.
Differentials
- Demencia tipo Alzheimer (DTA)
- Demencia con cuerpos de Lewy
- Demencia frontotemporal
More DifferentialsGuidelines
- Guidelines for decontamination of equipment for gastrointestinal endoscopy
- Endoscope disinfection update: a guide to resource-sensitive reprocessing
More GuidelinesLog in or subscribe to access all of BMJ Best Practice
Use of this content is subject to our disclaimer