French case report: probable DLB but autopsy confirmed CJD

Here’s an interesting case report in a French journal where the patient was initially thought to have probable dementia with Lewy bodies (DLB), then suffered an epileptic event, and upon autopsy was proven to have Creutzfeldt-Jakob disease (CJD or “mad cow disease” in humans). The abstract is copied below.
Robin

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Psychologie and Neuropsychiatrie du Vieilessement. 2007 Sep;5 Suppl 1:10-8.

[Pitfalls in the diagnosis of epilepsy in the elderly.][Article in French]

Harston S.
Pôle de Gériatrie, CHU de Bordeaux, France.

The current increase of life expectancy amplifies the visibility of the higher prevalence of epilepsy during the course of aging, first described in the 1970’s. The epileptic symptoms do not fundamentally differ after the age of 75 from those met in younger adults, but the increase in the frequency, on one hand, of other neurological conditions (especially dementias and their psycho-behavioral complications, and strokes) and, on the other hand, of non-specific geriatric syndromes such as delirium, can result in diagnostic mistakes detrimental for appropriate geriatric care. We report the case of a seventy-eight year old female patient who initially presented as a probable dementia with Lewy bodies, then featured a status epilepticus mainly revealed by a delirium first related to an iatrogenic event, followed by partial recovery, then presented a reversible non-situational status epilepticus, and was finally proven to have a Creutzfeldt-Jakob’s disease. If dementia is nowadays considered as one of the major elements to be taken into account in the organization of neurological and geriatric care, a pluridisciplinary approach should, in the same way, better define the place of diagnosis and care of epilepsy in older patients.

PubMed ID#: 17875496 (see pubmed.gov for English-language abstract only)