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Case Reports in Psychiatry
Volume 2011, Article ID 791275, 3 pages
http://dx.doi.org/10.1155/2011/791275
Case Report

Atypical Creutzfeldt-Jakob Disease Evolution after Electroconvulsive Therapy for Catatonic Depression

1Department of Psychiatry, Institute of Neurosciences, Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain
2Alzheimer's Disease and Other Cognitive Disorders Unit and CJD Unit, Department of Neurology, Institute of Neurosciences, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Hospital Clinic, 08036 Barcelona, Spain
3Neurological Tissue Bank, Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain
4Child and Adolescent Psychiatry and Psychology Department, Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain

Received 24 May 2011; Accepted 17 June 2011

Academic Editors: A. Cheng, C. Lançon, and P. Moberg

Copyright © 2011 Iria Grande et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We describe a case report of an 80-year-old woman who presented with symptomatology compatible with an episode of major depression with catatonia. After psychiatric admission, electroconvulsive therapy (ECT) was applied, but symptoms progressed with cognitive impairment, bradykinesia, widespread stiffness, postural tremor, and gait disturbance. After compatible magnetic resonance imaging (MRI), diffusion changes, and electroencephalogram (EEG) findings the case was reoriented to Creutzfeldt-Jakob disease (CJD). The genetic study found a methionine/valine heterozygosity at codon 129 of the prion protein gene PrPSc. On followup, a significant clinical recovery turned out. For this reason, EEG and MRI were repeated and confirmed the findings. The patient subsequently demonstrated progressive clinical deterioration and died 21 months later. The diagnosis was verified postmortem by neuropathology. The vCJD subtype MV2 is indeed characterized by early and prominent psychiatric symptoms and a prolonged disease duration however no frank clinical recovery has before been reported.