When to suspect iatrogenic Creutzfeldt-Jakob Disease (CJD):
(1) history of potential exposure
(2) onset of compatible clinical findings afterwards
(2a) dementia
(2b) ataxia
(2c) psychiatric disorder
(2d) visual disturbance
(2e) myoclonus, chorea or dystonia
(2f) painful sensory symptoms
(3) objective evidence for CJD on EEG, brain MRI or other study
(4) exclusion of other diagnoses
(5) exclusion of other sources of prion exposure
The clinical onset after the iatrogenic exposure range from 1 to 42 years afterwards.
Barriers to diagnosis:
(1) no data available about an exposure many years ago
(2) lower risk source (like contaminated EEG needles, blood transfusion)
(3) failure to consider the diagnosis
(4) failure to perform EEG or brain MRI
