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Established clinical criteria for diagnosing sporadic Creutzfeldt–Jakob disease (sCJD) rely heavily on symptoms that appear late in the disease, such as myoclonus or akinetic mutism.1,2 Previous studies identified cognitive, cerebellar, and behavioral symptoms as common early symptoms of CJD (table).3-6 These studies designated symptoms as “early” based on chart reviews or based on existing symptoms when patients first presented to a physician. This study evaluates the very first symptom, which often occurs before patients present to medical attention, in a large cohort of patients with sCJD.
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Table 1 Comparison of UCSF first symptom study with a number of previous early symptom studies
We reviewed over 400 potential CJD cases referred to the University of California San Francisco (UCSF) Memory and Aging Center from 2001 to 2004 and identified all cases of sCJD in which first symptoms were well documented. We included only cases of definite (pathology-proven) or probable CJD (World Health Organization [WHO] or modified Masters criteria).1,2 Cases …
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