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Creutzfeldt-Jakob disease and bovine spongiform encephalopathy

BMJ 1996; 312 doi: (Published 20 January 1996) Cite this as: BMJ 1996;312:180

Magnetic resonance imaging may have a role in diagnosing Creutzfeldt-Jakob disease

  1. Terence Featherstone
  1. Consultant radiologist Department of Radiology, Darlington Memorial Hospital, Darlington DL3 6HX

    EDITOR,—Creutzfeldt-Jakob disease1 is still rarely diagnosed in Britain, and neuropathological examination is required to confirm the diagnosis. Research in the United States, however, has shown the presence of bilaterally symmetric hyperintense abnormalities in the basal ganglia in T2 weighted magnetic resonance images in patients with pathologically proved Creutzfeldt-Jakob disease.2 This abnormality on magnetic resonance imaging was first reported in 1988.3 A colleague and I have reported Creutzfeldt-Jakob disease, with signal abnormalities in the basal ganglia on magnetic resonance imaging, in a 58 year old man with no occupational exposure to animals who presented with progressive dementia.4

    The prevalence of hyperintense abnormalities in the basal ganglia in T2 weighted images in patients with Creutzfeldt-Jakob disease has not been studied and remains unknown. Such hyperintense abnormalities in the basal ganglia can be seen in several disorders, but a combination of clinical features, laboratory findings, and imaging characteristics can be used to distinguish the other conditions from Creutzfeldt-Jakob disease. Although the absence of bilateral symmetric hyperintense lesions in the basal ganglia does not exclude Creutzfeldt-Jakob disease, it is reasonable to assume that their presence in patients with rapidly progressive dementia is a specific sign of the disease. It would be useful to know of other documented cases in which magnetic resonance imaging was carried out before death. Surely it would be worth while pursuing further research in this field and collating data from several centres with an interest in Creutzfeldt-Jakob disease to evaluate the role of magnetic resonance imaging in this condition.


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