[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-459097-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-459097-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","role-of-stress-as-a-precipitating-factor-of-creutzfeldt-jakob-disease-a-case-series","Role of Stress as a Precipitating Factor of Creutzfeldt-Jakob Disease: A Case Series","","Creutzfeldt-Jakob disease (CJD) is a rapidly progressive, invariably fatal neurodegenerative condition often mistaken for other neurological and psychiatric disorders and still frequently underdiagnosed due to difficult, late, and retrospective recognition. Its pathophysiology remains incompletely understood, and no intervention has proven effective for prevention or for altering morbidity and mortality. The report presents two clinical cases, highlighting natural history and challenging differential diagnosis while warning about a possible role of psychological and stressful factors in predisposition and/or precipitation.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/role-of-stress-as-a-precipitating-factor-of-creutzfeldt-jakob-disease-a-case-series/459097/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/role-of-stress-as-a-precipitating-factor-of-creutzfeldt-jakob-disease-a-case-series/459097.png","ImageObject",300,407,{"name":42,"@type":43},"CatatanPagi","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-04","2026-09-30",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",9,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"Why is Creutzfeldt-Jakob disease often misdiagnosed?","Question",{"text":63,"@type":64},"CJD is clinically heterogeneous and its neuropsychiatric and neurologic signs progress rapidly but commonly resemble other psychiatric and neurologic conditions, leading to suspicion based on progression and poor response to interventions.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What diagnostic elements are relied upon in this case series?",{"text":68,"@type":64},"Diagnosis requires exclusion of other etiologies and uses clinical features, imaging, EEG, and cerebrospinal fluid analysis, with confirmation requiring histopathological confirmation in a postmortem brain biopsy.",{"name":70,"@type":61,"acceptedAnswer":71},"How do the authors relate stress to CJD onset or progression?",{"text":72,"@type":64},"They discuss the stress hypothesis, in which hypothalamic-pituitary-adrenal axis pathways and stress-related inflammation may mediate CJD pathophysiology. The presented cases are described as consistent with stress factors acting as triggers.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},459097,1790791946,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":111,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":117,"preview_page_count":4},962090894170,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Review began 11/01/2025  \nReview ended 12/01/2025  \nPublished 12/09/2025  \n© Copyright 2025  \nRelvas et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98829  \nOpen Access Case Report  \nRole of Stress as a Precipitating Factor of Creutzfeldt-Jakob Disease: A Case Series  \nRita Relvas 1 , Cassiana Vasconcelos 1, André Buinho 2 , Nuno Monteiro 1, Sandra Castro Sousa 3  \n1. Internal Medicine Department, Hospital de Cascais, Lisbon, PRT 2. Psychiatry Department, Hospital de Cascais, Lisbon, PRT 3. Neurology Department, Hospital de Cascais, Lisbon, PRT  \nCorresponding author: Rita Relvas, [ritanfr@gmail.com](ritanfr@gmail.com)  \nAbstract  \nEasily mistaken for multiple neurological and psychiatric pathologies, Creutzfeldt-Jakob disease (CJD) is still underdiagnosed, with a difficult, late, and often retrospective recognition. Furthermore, its pathophysiology is poorly understood, and to date, no intervention has proven effective in its prevention or associated morbidity and mortality. The authors present a series of two clinical cases that not only expose its natural history and challenging differential diagnosis but also warn of a potential impact of psychological and stressful factors in its predisposition and/or precipitation.  \nCategories: Neurology, Internal Medicine, Infectious Disease  \nKeywords: creutzfeldt-jakob disease, functional neurological disorder, neurodegenerative disease, psychiatry and neuroscience, transmissible spongiform encephalopathy  \nIntroduction  \nCreutzfeldt-Jakob disease (CJD) is a rapidly progressive neurodegenerative disease with an underestimated incidence and inevitably fatal outcome, within one year in 70% of patients [1,2] .  \nBeing clinically heterogeneous, its neuropsychiatric symptoms, cerebellar manifestations, and pyramidal and extrapyramidal signs are commonly misjudged as other psychiatric and neurological conditions. It is their rapid progression and lack of response to interventions that raise suspicion. Diagnosis demands the exclusion of other etiologies and relies presumptively on clinical, imaging, electroencephalographic (EEG), and cerebrospinal fluid (CSF) analysis elements. Regardless, a conclusive diagnosis mandates histopathological confirmation in a postmortem brain biopsy. Nevertheless, mortality results from the absence of therapy capable of modifying disease progression, making treatment purely supportive.  \nThe main obstacle to the development of efficient therapeutic tools is a currently incomplete understanding of CJD pathophysiology. There are three established categories of disease: sporadic, genetic, and acquired. The first one is both the most common (85%-95% of cases) and the least understood, its risk factors and potential triggers remaining so far mostly unknown [3,4] . In this variant, the possible role of psychological and stressful events has been advocated. Known as the stress hypothesis, this theory proposes that hypothalamic-pituitary-adrenal (HPA) axis pathways and stress-related inflammation may act as mediatorsin CJD pathophysiology. However, not only is there scarce evidence to support this theory, but also its interpretation is made difficult by the clinical manifestations of CJD, marked by the presence of psychiatric symptoms itself.  \nThe case series here addressed provides further evidence on this topic, consistent with stress factors acting as CJD triggers. In addition, by reviewing and framing current knowledge on this topic, the authors went from clinical descriptions to a hypothesis-generating framework.  \nCase Presentation  \nCase 1  \nA 64-year-old woman with hypertension presented to the emergency room (ER) due to memory loss, gait imbalance, and behavioral changes (aggressiveness and delusions of persecution) . The onset of","cbCaih4M3GLdu2H6","https://ap.wps.com/l/cbCaih4M3GLdu2H6","pdf",1422269,"English","# Introduction\n## Disease overview and diagnostic challenges\n## Stress hypothesis and rationale\n# Case Presentation\n## Case 1\n# Case Series framing","[{\"question\":\"Why is Creutzfeldt-Jakob disease often misdiagnosed?\",\"answer\":\"CJD is clinically heterogeneous and its neuropsychiatric and neurologic signs progress rapidly but commonly resemble other psychiatric and neurologic conditions, leading to suspicion based on progression and poor response to interventions.\"},{\"question\":\"What diagnostic elements are relied upon in this case series?\",\"answer\":\"Diagnosis requires exclusion of other etiologies and uses clinical features, imaging, EEG, and cerebrospinal fluid analysis, with confirmation requiring histopathological confirmation in a postmortem brain biopsy.\"},{\"question\":\"How do the authors relate stress to CJD onset or progression?\",\"answer\":\"They discuss the stress hypothesis, in which hypothalamic-pituitary-adrenal axis pathways and stress-related inflammation may mediate CJD pathophysiology. The presented cases are described as consistent with stress factors acting as triggers.\"}]","Role of Stress as a Precipitating Factor of Creutzfeldt-Jakob Disease: A Case Series | PDF",1790755196]