Treatment-Resistant Depression With Catatonia Presenting as a Feature of Creutzfeldt-Jakob’s Disease
Coliseum Medical Centers
catatonia, creutzfeldt–jakob disease, pseudo-dementia, real-time quaking inverse conversion, 14-3-3, electroconvulsive therapy
Internal Medicine | Nervous System Diseases | Neurology | Psychiatry
A high-functioning middle-aged successful businessman developed a rapid decline in his cognitive, behavioral, and motor abilities within one year. He was initially diagnosed with dementia by a neurologist and was then diagnosed with pseudo-dementia secondary to major depressive disorder with catatonia by a psychiatrist who initiated treatment with Ativan. He was referred to our psychiatric facility for an evaluation to undergo electroconvulsive therapy (ECT) as a potential treatment for medically refractory depression complicated with catatonia and pseudo-dementia. The neurology team and internal medicine team were consulted by a psychiatrist for clearance to begin a course of ECT. In this process, with a coordinated effort and prompt workup and evaluation, including neurological testing, imaging, and positive cerebrospinal fluid analysis for real-time quaking inverse conversion (RT-QuIC) and 14-3-3, the patient was diagnosed with Creutzfeldt-Jakob’s disease.
There are many organic causes of dementia and catatonia that should be explored in depth, especially when the clinical picture is challenging and atypical.
Publisher or Conference
Uneib M, Devereaux R, Rutkofsky I H, et al. Treatment-Resistant Depression With Catatonia Presenting as a Feature of Creutzfeldt-Jakob’s Disease. Cureus. 2020 May 26;12(5):e8300. doi:10.7759/cureus.8300