Prion disease - Revision history

Kfarzam: /* Evaluation */

2022-08-20T05:45:29Z

Evaluation

← Older revision		Revision as of 05:45, 20 August 2022
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	==Evaluation==		==Evaluation==
	*'''Not''' an ED diagnosis, however MRI can raise significant suspicion and provide a presumptive diagnosis in the right clinical context		*'''Not''' an ED diagnosis, however MRI (if done) can raise significant suspicion and provide a presumptive diagnosis in the right clinical context
	*LP with CSF studies can be diagnostic		*LP with CSF studies can be diagnostic but should never be performed in the ED and must be done under special precautions
	*Evaluate for reversible/treatable causes of dementia		*Evaluate for reversible/treatable causes of dementia
	**CBC, B12, folate, thiamine		**CBC, B12, folate, thiamine

2022-08-20T05:44:54Z

Evaluation

← Older revision		Revision as of 05:44, 20 August 2022
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	==Evaluation==		==Evaluation==
	*'''Not''' an ED diagnosis, ~~as definitive~~ diagnosis ~~only possible by autopsy~~		*'''Not''' an ED diagnosis, however MRI can raise significant suspicion and provide a presumptive diagnosis in the right clinical context
			*LP with CSF studies can be diagnostic
	*Evaluate for reversible/treatable causes of dementia		*Evaluate for reversible/treatable causes of dementia
	**CBC, B12, folate, thiamine		**CBC, B12, folate, thiamine
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	**ETOH, [[Utox]], urine heavy metals		**ETOH, [[Utox]], urine heavy metals
	**RPR, ESR, ANA, HIV		**RPR, ESR, ANA, HIV
	**[[LP]]
	*[[brain MRI\|MRI]]:		*[[brain MRI\|MRI]]:
	**Areas of increased signal intensity bilaterally, mostly in caudate and putamen		**Areas of increased signal intensity bilaterally, mostly in caudate and putamen

2022-08-20T05:43:47Z

Management

← Older revision		Revision as of 05:43, 20 August 2022
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	==Management==		==Management==
	*No specific treatment		*No specific treatment, doxycycline has been used but evidence is weak
			*Ongoing research
	*Consider [[palliative care]] consult for symptom alleviation and support		*Consider [[palliative care]] consult for symptom alleviation and support

2022-08-20T05:43:14Z

Clinical Features

← Older revision		Revision as of 05:43, 20 August 2022
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	==Clinical Features==		==Clinical Features==
	*Progressive [[dementia]], behavioral changes, loss of cortical function over several months		*Progressive [[dementia]], behavioral changes, loss of cortical function over several months on average
	*Myoclonus		*Myoclonus
	*[[Extrapyramidal symptoms]] (hypokinesia)		*[[Extrapyramidal symptoms]] (hypokinesia)

2021-02-21T01:34:06Z

2019-10-02T22:39:09Z

← Older revision		Revision as of 22:39, 2 October 2019
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	*Evaluate for reversible/treatable causes of dementia		*Evaluate for reversible/treatable causes of dementia
	**CBC, B12, folate, thiamine		**CBC, B12, folate, thiamine
	**LFTs, BMP, TSH, [[Urinalysis]]		**[[LFTs]], BMP, TSH, [[Urinalysis]]
	**[[ECG]], [[CXR]]		**[[ECG]], [[CXR]]
	**ETOH, Utox, urine heavy metals		**ETOH, [[Utox]], urine heavy metals
	**RPR, ESR, ANA, HIV		**RPR, ESR, ANA, HIV
	**[[LP]]		**[[LP]]
	*MRI:		*[[brain MRI\|MRI]]:
	**Areas of increased signal intensity bilaterally, mostly in caudate and putamen		**Areas of increased signal intensity bilaterally, mostly in caudate and putamen
	**Posterior thalamic hyperintensity		**Posterior thalamic hyperintensity
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	==Management==		==Management==
	*No specific treatment		*No specific treatment
	*Consider palliative care consult for symptom alleviation and support		*Consider [[palliative care]] consult for symptom alleviation and support

	==Disposition==		==Disposition==

2017-04-04T11:44:40Z

2017-04-03T16:02:33Z

Evaluation

← Older revision		Revision as of 16:02, 3 April 2017
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	==Evaluation==		==Evaluation==
	*~~Definitive~~ diagnosis only possible by autopsy		*'''Not''' an ED diagnosis, as definitive diagnosis only possible by autopsy
	*Evaluate for reversible/treatable causes of dementia		*Evaluate for reversible/treatable causes of dementia
	**CBC, B12, folate, thiamine		**CBC, B12, folate, thiamine

2017-04-03T16:02:06Z

Management

← Older revision		Revision as of 16:02, 3 April 2017
Line 40:		Line 40:
	==Management==		==Management==
	*No specific treatment		*No specific treatment
			*Consider palliative care consult for symptom alleviation and support

	==Disposition==		==Disposition==

2017-04-03T16:01:35Z

Background

← Older revision		Revision as of 16:01, 3 April 2017
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	==Background==		==Background==
	*~~Fatal neurodegenerative disease~~		*Prions are misfolded proteinaceous particles
			**Replicate exponentially by causing properly folded proteins to misfold
			**Rapidly leads to neurodegeneration
			*Universally fatal
	*Transmissible forms:		*Transmissible forms:
	**Variant CJD acquired by consuming diseased tissues of cows (e.g. human form of mad cow disease) or other humans (kuru)		**Variant CJD acquired by consuming diseased tissues of cows (e.g. human form of mad cow disease) or other humans (kuru)