Frequency of Movement disorders in Peruvian Patients with Creutzfeldt-Jakob
Cintia Armas1, Yesenia Núñez1, Marcela Alvarado1, Gabriela Gushiken1, Miriam Vélez1, Rafael Suárez1, Luis Torres1, Danilo Sánchez1, Hugo Estrada1, Carlos Cosentino1
1Movement Disorder Unit, Instituto Nacional de Ciencias Neurológicas
Objective:

To evaluate the frequency and type of movement disorders (MD) in patients with CJD from at tertiary hospital in Peru.

Background:

Creutzfeldt-Jakob disease (CJD) is a rare, fatal, progressive neurodegenerative disease. It is characterized by cognitive impairment of subacute onset, rapid evolution, associated with behavioral symptoms, pyramidal signs, ataxia and movement disorders.

Design/Methods:
A detailed neurological examination, with special emphasis on movement disorders, was conducted in 15 consecutives symptomatic CJD patients 
Results:

A review of cases of inpatients with a diagnosis of CJD at the Instituto Nacional de Ciencias Neurológicas from 2017-2022 was carried out. Fifteen patients were evaluated. Nine female and 6 males.  The average age at the onset of the disease was 64.2 ± 7.59 years. The average time of illness until discharge or death was 5.9 ± 3.11 months. Ten patients (66.6%) had electroencephalogram with the presence of typical waves, 9/1 (60%) patients had positive 14-3-3 protein while 6/15 could not perform it, 13/15 (86.6%) patients had MRI with characteristic findings of CJD, only 2 did not have this study. The most frequent initial symptoms were cognitive impairment (60%) followed by movement disorders (53.33%), with ataxia being the most common; The movement disorders present in the patients were myoclonus (93.33%), ataxia (80%), parkinsonism (66.67%), dystonia (53.33%), alien limb phenomenon (33.33%), tremor (26.67%), fasciculations (6.67%) and gaze paralysis (6.67%), no patient had chorea. The sporadic CJD was the most frequent form. Myoclonus was noted in 14/15 patientes throughout the disease course also parkinsonism in 10/15 (66.67%). With 6.67% of cases were recorded as having an ataxic gait. In addition, most of the patients showed more than one movement throughout the disease course.

Conclusions:

Movement disorders are very common in CJD, with more than one type occurring during the course of the disease with, the myoclonus and ataxia as the most common.

10.1212/WNL.0000000000208136