Pearls from Dr. Laura Lennihan

Creutzfeldt-Jakob disease in a woman with 1-month of memory loss and myoclonus


  • Rapidly progressive dementia = poor learning/memory, language, attention, etc, over weeks/months

    Posted 05/29/16 04:13:27 PM by Matthew Cummings

  • Differential diagnosis of rapidly progressive dementia:

    Posted 05/29/16 04:15:52 PM by Matthew Cummings

  • Prion diseases (aka transmissible spongiform encephalopathies): rapidly progressive, invariably fatal neurodegenerative disorders caused by abnormal isoforms of specific glycoproteins ("prion proteins") in the brain

    Posted 05/29/16 04:21:47 PM by Matthew Cummings

  • Creutzfeldt-Jakob disease

    Posted 05/29/16 04:55:58 PM by Matthew Cummings

  • For further reading...

    Creutzfeldt-Jakob: clinical review (CID)
    Prion diseases: infection control considerations
    Review of pathogenesis and prion agent transmission in CJD
    CSF analysis in CJD

    Posted 05/29/16 05:01:17 PM by Matthew Cummings

  • 66 y/o man with intervals of AMS found to have Lewy body Dementia


  • Vascular causes of AMS are typically abrupt in onset
    Seizures can be non-convulsive and affect cognition
    Alzheimer's - Dementia advances before onset of motor symptoms

    MRI stroke protocol not as helpful as MRI Brain - given it does not have sagittal and T1 views. If not looking for acute stroke, can get full brain MRI for more information.

    Posted 07/28/16 02:20:09 PM by Adam Faye

  • Lewy Body Dementia: Need 2/3 "Core Clinical Features"

    Suggestive Features:
    1. REM sleep behavior disorder
    2. Neuroleptic sensitivity
    3. Repeated falls
    4. Syncope
    5. Autonomic dysfunction

    Posted 07/28/16 02:33:17 PM by Adam Faye

  • For further reading...

    Lewy Body Review
    Submandibular Bx for Dx?

    Posted 07/28/16 02:34:39 PM by Adam Faye

  • 52 yo woman with HIV presenting with 1 mo of abnormal behavior found to have anti-NMDA-receptor encephalitis


  • Neurological exam maneuver tricks:

    Posted 09/26/16 11:10:59 AM by Anna Krigel

  • Anti-NMDA-receptor encephalitis presentation:

    Posted 09/26/16 11:34:11 AM by Anna Krigel

  • Treatment algorithm for anti-NMDA-receptor encephalitis

    Posted 09/26/16 11:39:31 AM by Anna Krigel

  • For further reading...

    Recent Outcomes Article from AJRCCM
    Treatment and prognostic factors (Lancet Neurology)

    Posted 09/26/16 11:40:35 AM by Anna Krigel

  • 36 y/o with L arm weakness Dx with MS and Latent Syphilis


  • Multiple Sclerosis: 2010 McDonald Diagnostic Criteria 

    MRI with contrast: Will see hyperintense lesions (new) and hypontense lesions (old). Old lesions on T1 imaging will appear as black holes. 

    Posted 01/26/17 11:13:54 AM by Adam Faye

  • Multiple Sclerosis:

    Prognostic Markers: 
    -- Primary Progressive – more rapid disease progression
    -- Men progressed more quickly but outcomes not affected
    -- Type of symptoms at onset did not predict disease progression

    Primary Care Needs;

    Posted 01/26/17 11:22:14 AM by Adam Faye

  • Acute MS Exacerbations:

    Posted 01/26/17 11:26:45 AM by Adam Faye

  • Ocrelizumab for MS:

    Posted 01/26/17 11:31:32 AM by Adam Faye

  • 58yo F with rapidly progressive dementia ultimately diagnosed with CJD


    47yoM w/ poorly controlled HIV p/w LLE weakness 2/2 VZV transverse myelitis


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