Creutzfeldt-Jakob Disease (CJD) is a neurological degenerative prion disease with a long incubation period but a rapidly progressive course after the onset of symptoms. Clinical onset is characterized in most cases by neurological symptoms, while in a much smaller percentage by signs of mental deterioration and psychiatric symptoms.
We describe the case of an elderly female patient who presented with psychotic symptoms in the absence of neurological signs and symptoms, and after systematic diagnostic evaluation eventually turned out to be a sporadic CJD case.
In clinical practice CJD should not be neglected as differential diagnosis in elderly patients with negative psychiatric history referring to psychiatrists for recent onset and rapidly progressing symptoms as behavior changes, anxiety, irritability, mood deflection, insomnia and poor response to treatment. In the case we reported, indeed, the symptoms necessary to diagnose a possible sporadic form of CJD, as focal neurological deficits or apraxia, emerged only belatedly, at a final stage, while symptoms at onset appeared to be purely psychiatric.