Question:
A 70-year-old patient presents with intermittent myoclonic jerks of recent onset, and the EEG shows bilateral periodic spike-wave complexes. What is the most probable diagnosis?
A 70-year-old patient presents with intermittent myoclonic jerks of recent onset, and the EEG shows bilateral periodic spike-wave complexes. What is the most probable diagnosis?
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Rapidly progressive dementia with myoclonus and periodic EEG complexes in an elderly patient.
Updated On: Jun 24, 2026
- Herpes simplex encephalitis
- Lewy body dementia
- Alzheimer's disease
- Creutzfeldt-Jakob disease (CJD)
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Verified By Collegedunia
The Correct Option is D
Solution and Explanation
Step 1: Identify the classic triad described. An elderly patient with rapidly progressive cognitive decline plus myoclonus (intermittent jerks) plus periodic complexes on EEG is the textbook presentation of Creutzfeldt-Jakob disease.
Step 2: Interpret the EEG. Bilateral periodic sharp-wave or spike-wave complexes (typically 1 to 2 Hz, often synchronous with the myoclonic jerks) are highly characteristic of sporadic CJD, a prion disease causing spongiform encephalopathy.
Step 3: Exclude the other options. Herpes simplex encephalitis affects the temporal lobes with fever, seizures and periodic lateralised epileptiform discharges (PLEDs), usually in a different clinical context. Lewy body dementia features fluctuating cognition, visual hallucinations and parkinsonism, not periodic EEG spikes. Alzheimer's disease is a slowly progressive amnestic dementia without early myoclonus or periodic complexes.
Step 4: Conclusion. The combination of recent-onset myoclonus and periodic bilateral EEG spikes in an elderly patient points to CJD.
The medically correct and printed answer is option 4 (CJD).
Step 2: Interpret the EEG. Bilateral periodic sharp-wave or spike-wave complexes (typically 1 to 2 Hz, often synchronous with the myoclonic jerks) are highly characteristic of sporadic CJD, a prion disease causing spongiform encephalopathy.
Step 3: Exclude the other options. Herpes simplex encephalitis affects the temporal lobes with fever, seizures and periodic lateralised epileptiform discharges (PLEDs), usually in a different clinical context. Lewy body dementia features fluctuating cognition, visual hallucinations and parkinsonism, not periodic EEG spikes. Alzheimer's disease is a slowly progressive amnestic dementia without early myoclonus or periodic complexes.
Step 4: Conclusion. The combination of recent-onset myoclonus and periodic bilateral EEG spikes in an elderly patient points to CJD.
The medically correct and printed answer is option 4 (CJD).
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