[Long-term EEG course study in patients with Creutzfeldt-Jacob disease]

In a patient with Creutzfeldt-Jakob disease subsequently confirmed by autopsy, 34 EEGs were carried out in a 14 months period. 6 weeks after the beginning of the prodromal stage of the disease a triphasic, periodic activity was recorded for the first time. This activity was maximally in evidence at 15th week. A synchrony occurring between repetitive complexes and myoclonic jerks could between repetitive complexes and myoclonic jerks could only be observed during one recording. From the 5th month onwards the intensity of the periodic EEG pattern, seen longitudinally, gradually decreased. In the time-span from the 10th to the 13th month considerable fluctuations of periodic activity were found, this during the course of one as well as between different EEG recordings. These could reach from a pronounced typical pattern to complete disappearance of periodic triphasic complexes. As possible causes for these fluctuations, we discussed a variable driving by the subcortical pacemaker as well as a decreased capability of cerebral cortex--gradually loosing so many neurons--to react to subcortical stimuli. From the 14th month onwards the periodic activity no longer could be put in evidence. In the last EEG recorded 3 days before death isoelectric periods alternated with paroxysmal delta waves respectively sharp and slow wave complexes.