Creutzfeldt-Jakob disease: a survey of 14 patients

Creutzfeldt-Jakob disease (CJD) is a transmissible disease of the nervous system causatively related to the presence of an abnormal prion protein, with dementia, myoclonic jerks, and periodic EEG activity. Fourteen patients (7 females and 7 males) ranging from 26 to 76 years of age (median 59 years) were evaluated between 1974 and 1995 at the Neurologic Clinic of Sao Paulo University School of Medicine. The average duration of the disease was 12 months (3.5 - 34 months). Early clinical findings were: behaviour changes in 7 patients, dementia in 4, visual disturbances in 4, vertigo in 2, tremor in 9, and dystonia in one. Advanced symptoms were dementia and myoclonus in all patients. Pyramidal tract dysfunction was found in 6, cerebellar ataxia in 2, seizures in 3, nystagmus and vertigo in 4, and peripheral nervous system involvement in 2. Atypical clinical forms were found in 5 patients. Periodic EEG activity was found in 10 patients. Cerebrospinal fluid evaluation showed pleocytosis in 1 patient, higher protein content in 2, and higher gamma globulin level in 2. In 10 patients anatomopathological evidence in the central nervous system confirmed the clinical diagnosis by presenting with status spongiosus. All except one patient presented with the sporadic form of the disease.

Considerations on HAM/TSP: rediscovering Tumaco

Säo feitas consideraçöes acerca do papel etiopatogênico do HTLV-I na paraplegia espástica tropical (TSP), a mielopatia associada ao HTLV-I (HAM). Aspectos neuroepidemiológicos registrados na literatura säo reavalidados com essa finalidade. Da avaliaçäo resultam perspectivas para novos estudos. Para estes, é salientado que a Comunidade do Okinawa no Brasil apresenta, características étnicas e demográficas ideais. Análises sobre o HTLV-I e a HAM/TSP emconfronto a coorte populacional dessa comunidade classificada de acordo com o tempo e o sentido da corrente migratória (Japäo-Brasil e vice versa) poderäo, por exemplo, garantir resultados promissores para a compressäo da etiopatogenia da HAM/TSP. Poderäo constituir-se também em caminho para esclarecer a origem simultânea de focos geográficos da doença täo distantes entre si como o de Tumaco e o do sul do Japäo