Periodic sharp wave complexes on EEG in Creutzfeldt-Jakob disease

Sporadic Creutzfeldt-Jakob disease · Periodic

Generalized sharp complexes at 1 Hz on an attenuated background; jerks are time-locked to some. Simulated trace, longitudinal bipolar channels. Open in the interactive viewer

What it looks like

Generalized bi- or triphasic sharp complexes repeating about once a second on a background that becomes progressively featureless. In ACNS terms these are GPDs; the label carries the clinical context. 20

What it means at the bedside

With rapidly progressive dementia and myoclonus this supports sporadic CJD. Sensitivity is roughly two thirds over the course of the illness (64% in an autopsy-controlled series, specificity 91%), so a normal early EEG excludes nothing. Lateralized at first in some patients. 20

PeriodicGeneralizedRapid dementia

Sources

  1. Steinhoff BJ, et al. Diagnostic value of periodic complexes in Creutzfeldt-Jakob disease. Ann Neurol 2004;56:702–708. doi.org/10.1002/ana.20261

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