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Alejandro A. Rabinstein, MD; Michelle L. Whiteman, MD; Robert T. Shebert, MD

Arch Neurol. 2002;59:637-639.

Background  The value of magnetic resonance imaging of the brain in the diagnosis of iatrogenic cases of Creutzfeldt-Jakob disease has been questioned.

Objective  To illustrate the value of magnetic resonance imaging of the brain in the diagnosis of iatrogenic Creutzfeldt-Jakob disease.

Methods  Case report.

Results  A patient with a history of 3 corneal transplantations exhibited the alien hand sign on initial examination. Diffusion-weighted magnetic resonance imaging of the brain revealed prominent cortical diffusion abnormalities. During the following months, the patient developed rapidly progressive dementia. The diagnosis of Creutzfeldt-Jakob disease was proven by brain biopsy.

Conclusion  Brain magnetic resonance imaging, particularly diffusion-weighted magnetic resonance imaging, can be very helpful in the diagnosis of Creutzfeldt-Jakob disease, even in suspected iatrogenic cases.

From the Departments of Neurology (Drs Rabinstein and Shebert) and Neuroradiology (Dr Whiteman), University of Miami School of Medicine, Miami, Fla.

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