Disclosures: Jared Astrow, DO: No financial relationships or conflicts of interest

Case Description: 74-year-old male with a history of CAD, HLD, and HTN who presented with a four-month history of progressive confusion and disorientation. MRI revealed bilateral medial temporal flair and right occipital and parietal lobe enhancement. Workup was negative for infectious, autoimmune and neoplastic process with no etiology found. A CSF sample was sent to the CDC laboratory for further analysis, including for Creutzfeldt-Jakub’s disease (CJD). The patient was empirically started on high-dose methylprednisolone regimen and IVIG for possible autoimmune encephalitis, with improvements in cognition and admitted to acute inpatient rehabilitation. During his 14-day admission his Cognitive-log (C-LOG) score improved from 11/30 to 21/30. Functionally he improved and on discharge he performed bed mobility with supervision and required contact guard assistance for transfers, ambulation, and stairs. Given his functional and cognitive improvements he was discharged home after family training. The results returned from the CSF samples which were positive for CJD. The patient was transitioned to hospice care and passed away at home with his family.

Setting: Inpatient Rehabilitation Facility

Patient: 74-year-old male with CJD. Assessment/

Results: The patient made progress with overall improvement in self-care tasks, ambulation, stairs, transfers, and cognition, however continued to have impairments in apraxia, dynamic balance, myoclonus and orientation.

Discussion: CJD is a rare neurodegenerative disorder with a poor prognosis. This case provides insight into the course of the disease, given his clinical improvements with a course of intensive multidisciplinary rehabilitation. It also highlights a role for inpatient rehabilitation in patients with CJD, enabling family training, equipment assessment, and cognitive/mobility improvements allowing a safe discharge home.

Conclusion: The role for acute inpatient rehabilitation has not been previously described in patients with Creutzfeldt-Jakub disease. The acute rehab setting can be therapeutic for patients with CJD and provide the functional gains and family training necessary for a safe transition home.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/rehabilitation-in-a-patient-with-creutzfeldt-jakub-disease-a-case-report/