title: First hundred cases of variant Creutzfeldt-Jakob disease: retrospective case note review of early psychiatric and neurological features.
abstract: OBJECTIVE
  To describe the early psychiatric and neurological features of variant Creutzfeldt-Jakob disease.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  National surveillance system for Creutzfeldt-Jakob disease in the United Kingdom.
  
  
  METHODS
  The first 100 cases of variant Creutzfeldt-Jakob disease identified in the United Kingdom.
  
  
  METHODS
  The timing and nature of early psychiatric and neurological symptoms in variant Creutzfeldt-Jakob disease.
  
  
  RESULTS
  The early stages of variant Creutzfeldt-Jakob disease are dominated by psychiatric symptoms, but neurological symptoms precede psychiatric symptoms in 15% of cases and are present in combination with psychiatric symptoms in 22% of cases from the onset of disease. Common early psychiatric features include dysphoria, withdrawal, anxiety, insomnia, and loss of interest. No common early neurological features exist, but a significant proportion of patients do exhibit neurological symptoms within 4 months of clinical onset, including poor memory, pain, sensory symptoms, unsteadiness of gait, and dysarthria.
  
  
  CONCLUSIONS
  Although the diagnosis of variant Creutzfeldt-Jakob disease may be impossible in the early stages of the illness, particular combinations of psychiatric and neurological features may allow early diagnosis in an appreciable proportion of patients.
authors.affiliation: Department of Psychiatry, Addenbrooke's Hospital, Cambridge CB2 2QQ, UK. r.g.will@ed.ac.uk
authors.forename: Michael D
authors.initials: MD
authors.lastname: Spencer
authors.forename: Richard S G
authors.initials: RS
authors.lastname: Knight
authors.forename: Robert G
authors.initials: RG
authors.lastname: Will
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D002648:Child; D015331:Cohort Studies; D007562:Creutzfeldt-Jakob Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D001523:Mental Disorders / Q000209:etiology*; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors