Creutzfeldt-Jakob Disease: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

  • General physical examination – including blood pressure, pulse, body weight, height; further:
    • Inspection (viewing).
      • Skin, mucous membranes, and sclerae (white part of the eye) [tremor (muscle tremors); myoclonus (involuntary muscle twitching); paralysis; incoordination]
    • Inspection (viewing) and palpation (palpation) of the thyroid gland [due todifferential diagnosis: Hashimoto’s encephalopathy (form of brain change caused by thyroid hormones]
    • Palpation (palpation) of the abdomen (abdomen) (tenderness?, knocking pain?, coughing pain?, defensive tension?, hernial orifices?, kidney bearing knocking pain?) [Hepatic encephalopathy – central nervous system (CNS) dysfunction caused by acute or chronic liver disease (differential diagnosis)]
  • Neurologic examination – including reflex testing, motor/sensory examination, and cranial nerve testing. [due tosymptoms:
    • Akinetic mutism (inhibition of all motor functions including speech).
    • Ataxia (disturbance in the sequence of movement).
    • Chorea (involuntary rapid sweeping movements).
    • Coordination disorders
    • Paralysis
    • Myoclonus (involuntary muscle twitching).
    • Painful dysesthesias (sensory disturbances)]

    [due todifferential diagnoses:

    • Alcoholism
    • Dementias of all kinds
    • Encephalitis (inflammation of the brain)
    • Alzheimer’s disease
    • Parkinson’s disease
    • Multisystem atrophy (degenerative neurological disease similar to Parkinson’s disease, but much more severe and rapid).
    • Normal pressure hydrocephalus (“hydrocephalus”, which does not lead to an increase in pressure due to a simultaneous reduction in brain tissue).
    • Progressive multifocal leukoencephalopathy (demyelinating disease of the brain).
    • Progressive myoclonic epilepsy (progressive form of epilepsy).
    • Psychiatric disorders]

Square brackets [ ] indicate possible pathological (pathological) physical findings.