A 38-year-old man presents with a 6-month history of progressive tremor, dysarthria, and cognitive decline. Vital signs: BP 128/82, HR 88, RR 16, Temp 37.2°C, SpO2 98% on room air. Brain MRI demonstrates cortical ribboning and basal ganglia hyperintensity on DWI sequences. CSF analysis reveals elevated 14-3-3 protein and positive RT-QuIC. EEG shows periodic sharp wave complexes. Serum protein electrophoresis is normal. Which of the following is the most likely diagnosis?

  1. A)Multiple system atrophy
  2. B)Creutzfeldt-Jakob diseaseGABARITO
  3. C)Progressive supranuclear palsy
  4. D)Parkinson disease with dementia
  5. E)Alzheimer disease

Explicação

Creutzfeldt-Jakob disease (CJD) is a rapidly progressive spongiform encephalopathy. The combination of cognitive decline, tremor, dysarthria, elevated 14-3-3 protein in CSF, periodic sharp wave complexes on EEG, and DWI hyperintensity in cortex and basal gangl... Ver explicação completa e trilha adaptativa →

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