title: Onset of vulvodynia in a woman ultimately diagnosed with Creutzfeldt-Jakob disease.
abstract: BACKGROUND
  Vulvodynia, defined as vulvar pain or burning in the presence of normal vulvar appearance, is common and is associated with chronic pain syndromes and psychiatric disorders.
  
  
  METHODS
  A postmenopausal woman complained of vulvar burning. Causes for vulvar burning including yeast infection, estrogen deficiency, and contact dermatitis were excluded. Vulvovaginal examination was normal. Subsequently, she complained of headaches, insomnia, and depression. She developed ataxic gait with rapidly progressive dementia. Brain biopsy confirmed the diagnosis of Creutzfeldt-Jakob disease, and 3 weeks later she lapsed into coma and died.
  
  
  CONCLUSIONS
  This report is unique in that a rare disease, known to result in neuronal damage, mimicked symptoms of vulvodynia in its initial phase. This supports the hypothesis that vulvodynia is a neuropathic syndrome originating in the nervous system.
authors.affiliation: From the Division of Infectious Diseases, Department of Neurology, and Department of Pathology, Wayne State University School of Medicine, Detroit, Michigan.
authors.forename: Orna
authors.initials: O
authors.lastname: Reichman
authors.forename: Alexandros
authors.initials: A
authors.lastname: Tselis
authors.forename: William J
authors.initials: WJ
authors.lastname: Kupsky
authors.forename: Jack D
authors.initials: JD
authors.lastname: Sobel
mesh_terms: D007562:Creutzfeldt-Jakob Syndrome / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D056650:Vulvodynia / Q000209:etiology*