Probable Sporadic Creutzfeldt-Jakob Disease Presenting as Refractory Status Epilepticus in a Poststroke Epilepsy Patient: A Case Report

Junki SOGANO; Kenzo KOSUGI; Atsushi OKANO; Yoshihiro NIHEI; Narumi WATANABE; Jin NAKAHARA; Masahiro TODA

doi:10.2176/jns-nmc.2023-0166

CASE REPORT

Probable Sporadic Creutzfeldt-Jakob Disease Presenting as Refractory Status Epilepticus in a Poststroke Epilepsy Patient: A Case Report

Junki SOGANO, Kenzo KOSUGI, Atsushi OKANO, Yoshihiro NIHEI, Narumi WATANABE, Jin NAKAHARA, Masahiro TODA

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Keywords: sporadic Creutzfeldt-Jakob disease, focal epilepsy, refractory status epilepticus, lateralized periodic discharges, generalized periodic discharges

JOURNAL OPEN ACCESS FULL-TEXT HTML

2023 Volume 10 Pages 349-354

DOI https://doi.org/10.2176/jns-nmc.2023-0166

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Abstract

In this study, we report on a case of probable sporadic Creutzfeldt-Jakob disease (sCJD) diagnosed after a difficult course of status epilepticus (SE) in a patient with poststroke epilepsy. The patient was admitted with progressive cognitive decline and convulsive SE; therefore, it was initially thought that the patient had developed SE due to nonadherence to antiseizure medication (ASM) use, but despite treatment with ASMs after admission, no improvement was noted in consciousness disturbance or lateralized periodic discharges (LPDs) on electroencephalogram (EEG) examination. After a refractory course, the progression of LPDs to generalized periodic discharges (GPDs) on EEG and abnormal magnetic resonance imaging (MRI) findings met the diagnostic criteria of sCJD. Even if the patient had epilepsy, such as poststroke epilepsy, as in this case, it is essential to consider other underlying causes, including CJD in cases of superrefractory SE.

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