Skip to main content
AAPM&R 2025 Main banner
JFK
Final Program


Official Program
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Presentation Icons
On Demand
On Demand
In-Person
In-Person
Livestream
Livestream
Invite Only
Invite Only
Ticketed
Ticketed
Coffee Break
Coffee Break
Meal
Meal
Reception
Reception
Rate ePoster

General Rehabilitation

Creutzfeldt-Jakob Disease in an Inpatient Rehabilitation Facility

Friday, October 24, 2025
8:00 AM - 9:15 AM MT
Location: Kiosk 2

    Primary Author(s)

  • Adam T. Schulman, MD (he/him/his)

    Resident Physician
    Icahn School of Medicine At Mount Sinai PM&R Program
    Piscataway, New Jersey

    • Co-Author(s)

  • TD

    Tava J. DeQuattro, DO

    Resident
    Icahn School of Medicine At Mount Sinai PM&R Program
    New York, New York

  • Eric Jones, MD

    Resident Physician
    Icahn School of Medicine At Mount Sinai PM&R Program
    New York, New York

  • CT

    Carley Trentman, MD

    Assistant Professor
    Icahn School of Medicine At Mount Sinai PM&R Program
    New York, New York

Disclosure(s):
Adam T. Schulman, MD: No financial relationships to disclose
Tava J. DeQuattro, DO: No financial relationships to disclose
Case Diagnosis: Subacute cerebellar ataxia with concern for Creutzfeldt-Jakob disease

Case Description or Program Description: A 67-year-old female with a medical history of severe aortic stenosis and valve replacement, hypertension, and hyperlipidemia presents with a 2 month gradual history of gait imbalance, weakness, and memory issues (both short and long term). The only localizing finding on the physical exam was cerebellar ataxia.

Setting: Inpatient rehabilitation service

Assessment/Results: Labs were significant for low-normal B12, low-normal thiamine, and grossly normal inflammatory panels and heavy metals. MRI brain revealed symmetric diffusion restriction in the bilateral thamali, caudate, and cingulate gyri as well as punctate infarct in the left cortex. A broad work up including MRI cervical/thoracic, MRA head/neck, MRV head, CT Chest, abdomen, pelvis, PET scan, and EEG all revealed no abnormalities. Of note, while in rehab her memory progressively worsened and she began to have urinary incontinence. Given the above MRI findings and otherwise insignificant workup, the differential was broad but CJD was suspected. Lumbar puncture as completed however 14-3-3 is still pending.

Discussion (relevance): CJD is a neurodegenerative prion disease affecting 1-2 per million individuals worldwide per year. The most common clinical manifestations are rapidly progressive dementia and startle myoclonus, however psychiatric symptoms, cerebellar dysfunction, upper motor neuron and extrapyramidal signs may also be present. Diagnosis is supported by hyperintensity in the cortex and corpus striatum on DWI MRI, presence of 14-3-3 and tau protein in CSF, and periodic sharp wave complexes on EEG. RT-QuIC CSF assay is highly sensitive and specific for the diagnosis. There is no effective treatment for CJD and the disease is often fatal within one year of symptom onset.

Conclusions: CJD is rare and may present with cerebellar manifestations as in this case. Though there is no effective treatment for the disease, rehab may play a role in improving functionality and ambulation.