A 70-year-old man presents with rapidly progressive dementia over 4 months, accompanied by myoclonus and visual disturbances. EEG shows periodic sharp wave complexes. MRI shows hyperintensity in the caudate nucleus and putamen on DWI sequences. Which of the following is the most likely diagnosis?

• A Alzheimer disease
• B Frontotemporal dementia
• C Lewy body dementia
• D Creutzfeldt-Jakob disease ✓

Explanation

Creutzfeldt-Jakob disease (CJD) presents with rapidly progressive dementia (weeks to months), myoclonus, and characteristic periodic sharp wave complexes on EEG. MRI DWI shows hyperintensity in the basal ganglia (caudate/putamen) and cortical ribboning. Alzheimer disease progresses over years without myoclonus early. Lewy body dementia has fluctuating cognition and parkinsonism. Frontotemporal dementia presents with behavioral or language changes, not myoclonus or periodic EEG complexes.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.