Electroencephalography distinguished anti-N-methyl-D-aspartate receptor encephalitis and Creutzfeldt-Jakob disease

Creutzfeldt-Jakob disease (CJD) and anti-NMDA receptor (anti-NMDAR) encephalitis are two diseases with different progression and prognosis, so it is crucial to distinguish them early. Here we retrospectively studied the medical records of patients with CJD and anti-NMDAR encephalitis diagnosed between November 1, 2011 and March 1, 2022. More patients had seizures in anti-NMDA receptor encephalitis group than in CJD group. Anti-NMDAR encephalitis patients had much higher cerebrospinal fluid (CSF) leukocyte counts while patients with CJD had higher CSF albumin count. Extensive cortical signal abnormalities were more common in CJD, whereas limbic system signal abnormalities showed no significant trend toward higher frequency in anti-NMDAR encephalitis. Generalized Periodic Discharges (GPDs) and GPDs with triphasic morphology and A-P lag (GPDsA-P) in continuous EEG of patients with CJD were significantly different from those in anti-NMDAR encephalitis. There were no differences in periodic sharp compound waves in the continuous EEG of the two groups. In conclusion, we present distinguishing features between CJD and anti-NMDAR encephalitis, and EEG can be used as a reliable auxiliary diagnosis to distinguish between two diseases.