Sporadic Creutzfeld Jakob Disease is a rare disease with diagnostic challenges. While there is very little human data regarding this disease, some studies have indicated that certain medications may be useful in slowing its progression. Case study data implies psychiatric and cognitive symptoms preceding the diagnosis. This single case report presents a 68-year-old male with suspected late-onset bipolar disorder, later found to have sporadic Creutzfeld Jakob Disease. The patient was treated with lithium for this purported bipolar disorder. Approximately 2 years later, the patient met the Center for Disease Control (CDC) diagnostic criteria for prion disease following a rapid decline in cognition. This case provides an example of a medical mimic of bipolar disorder in the geriatric population.
FreudenreichO.Differential diagnosis of psychotic symptoms: medical mimics. Psychiatr Times2012; 27: 51–61.
2.
McKeeJBrahmN.Medical mimics: differential diagnostic considerations for psychiatric symptoms. Ment Health Clin2016; 6: 289–296.
3.
SoodTRMcstayCM.Evaluation of the psychiatric patient. Emerg Med Clin North Am2009; 27: 669–683, ix.
4.
JurdiRAPulakhandamSKunikME, et al. Late-life mania: assessment and treatment of late-life manic symptoms. Geriatrics2005; 60: 18–23.
5.
WiseMG.RudeilJrTextbook of consultation and liaison psychiatry. 2nd ed. Arlington, VA: American Psychiatric Publishing, Inc., 2002.
6.
KimSHYuMMStruttAM.Variably protease-sensitive prionopathy: a differential diagnostic consideration for dementia. Neurol Clin Pract2019; 9: 145–151.
7.
MastersCLHarrisJOGajdusekDC, et al. Creutzfeldt-Jakob disease patterns of worldwide occurrence and the significance of familial and sporadic clustering. Ann Neurol1979; 5: 177–188.
8.
ChandraSRIssacTGPhilipM, et al. Creutzfeldt-Jakob disease phenotype and course: our experience from a tertiary center. Indian J Psychol Med2016; 38: 438–442.
9.
ApplebyBSApplebyKKCrainBJ, et al. Characteristics of established and proposed sporadic Creutzfeldt-Jakob disease variants. Arch Neurol2009; 66: 208–215.
10.
LaplancheJ-LHachimiKHEDurieuxI, et al. Prominent psychiatric features and early onset in an inherited prion disease with a new insertional mutation in the prion protein gene. Brain1999; 122: 2375–2386.
11.
NasreddineZSPhillipsNABedirianV, et al. The Montreal cognitive assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc2005; 53: 695–698.
12.
MorrisJ.Clinical dementia rating: a reliable and valid diagnostic and staging measure for dementia of the Alzheimer type. Int Psychogeriatr1997; 9: 173–176.
13.
ManningRT.The serial sevens test. Arch Intern Med1982; 142: 1192.
14.
WhyteCAPetrockAMRosenbergM.Occurrence of physiologic gaze-evoked nystagmus at small angles of gaze. Invest Ophthalmol Vis Sci2010; 51: 2476–2478.
McClureJBSwanGECatzSL, et al. Smoking outcome by psychiatric history after behavioral and varenicline treatment. J Subst Abuse Treat2010; 38: 394–402.
17.
Relano-GinesALehmanSBrillaudE, et al. Lithium as a disease-modifying agent for prion disease. Transl Psychiatry2018; 8: 163–174.
18.
SchwartzMBrandelJBabonneauML, et al. Genetic testing in prion disease: psychological consequences of the decisions to know or not know. Front Genet2019; 10: 1–7.
19.
OwenJBeckJCampbellT, et al. Predictive testing for inherited prion disease: report of 22 years experience. Eur J Hum Genet2014; 22: 1351–1356.
20.
ConnorAWangHApplebyBS, et al. Clinical laboratory tests used to aid in diagnosis of human prion disease. J Clin Microbiol2019; 57: e00769–19.
21.
FoutzAApplebyBSHamlinC, et al. Diagnostic and prognostic value of human prion detection in cerebrospinal fluid. Ann Neurol2017; 81: 79–92.
22.
FranceschiniABaiardiSHughsonAG, et al. High diagnostic value of second generation CSF RT-QuIC across the wide spectrum of CJD prions. Sci Rep2017; 7: 1065510655.
