Concerns About Mad Cow Disease: Symptoms, Tests, and Specialist Recommendations

I suspect that I have mad cow disease (Creutzfeldt-Jakob disease)?

Two weeks ago, after having Japanese barbecue with my girlfriend, I experienced a week-long headache and temporary memory loss, where I would forget what I did earlier that day in the afternoon, having no recollection at all.
I had a severe headache, and during the barbecue, I particularly enjoyed eating beef from various cuts.
I am concerned that I might have contracted Creutzfeldt-Jakob disease (CJD).
May I ask, doctor: 1.
What kind of tests should I undergo for diagnosis? I have heard that X-rays are not very helpful in diagnosing CJD? 2.
If I need to have an electroencephalogram (EEG), does health insurance cover part of the cost? If not, how much would it typically cost? 3.
I live in the Kaohsiung-Pingtung area; could you recommend any specialized doctors or hospitals regarding CJD? Thank you.

Zhang Tongxue, 20~29 year old female. Ask Date: 2008/07/05

Dr. Lin Zijing reply Neurology

Bovine spongiform encephalopathy, officially known as variant Creutzfeldt-Jakob disease (vCJD), was first identified in 1996 in the United Kingdom.
Creutzfeldt-Jakob disease (CJD) itself was discovered as early as 1920.
Both conditions exhibit similar pathological changes in the brain, but their clinical presentations differ.
CJD typically occurs in older adults, while vCJD primarily affects younger individuals, with an average age of onset around 29 years.
The incubation period for vCJD can be quite prolonged, potentially lasting several years.

Patients with vCJD initially present with psychiatric symptoms, such as depression, anxiety, and hallucinations.
Gradually, they may experience unsteady gait, difficulties in movement, and involuntary muscle contractions (myoclonus), ultimately leading to cognitive decline, complete bed confinement, and most patients succumb to infectious diseases within a year of onset.
As of now, there have been no reported cases of variant Creutzfeldt-Jakob disease in Taiwan.
Furthermore, your symptoms are quite different from those of vCJD; however, if your symptoms persist without improvement, it is advisable to seek assistance from a neurologist.
If you wish to consult an expert on Creutzfeldt-Jakob disease, you may contact Dr.
Shun-Sheng Chen, the Deputy Director of Kaohsiung Chang Gung Memorial Hospital.

Reply Date: 2008/07/05

More Info

Mad Cow Disease, or Bovine Spongiform Encephalopathy (BSE), is a neurodegenerative disease that affects cattle and can lead to a variant form of Creutzfeldt-Jakob Disease (vCJD) in humans. Your concerns about experiencing headaches and temporary memory loss after consuming beef are understandable, especially given the serious nature of BSE and its human variant. However, it is important to note that the likelihood of contracting vCJD from consuming beef is extremely low, particularly in countries where strict regulations on cattle feed and meat processing are enforced.

Symptoms of vCJD
The symptoms of variant Creutzfeldt-Jakob Disease typically include:
- Psychiatric Symptoms: These can include depression, anxiety, and behavioral changes.

- Neurological Symptoms: Patients may experience memory loss, confusion, and difficulty with coordination and balance. Severe headaches can also occur.

- Visual Disturbances: Some individuals may experience visual problems, including blurred vision or hallucinations.

The symptoms you described, particularly the headaches and temporary memory loss, could be attributed to a variety of other conditions, such as stress, anxiety, or even a migraine. It is crucial to consider other potential causes before jumping to conclusions about vCJD.

Recommended Tests
1. MRI (Magnetic Resonance Imaging): This imaging test can help identify changes in the brain associated with vCJD, such as specific patterns of brain atrophy.

2. EEG (Electroencephalogram): While EEGs can show abnormal brain activity, they are not definitive for diagnosing vCJD. However, they can help rule out other conditions.

3. Lumbar Puncture: This test can analyze cerebrospinal fluid for certain proteins associated with prion diseases, although it is not commonly performed for vCJD.

X-rays are indeed not useful for diagnosing vCJD, as they do not provide information about brain structure or function.

Health Insurance and Costs
Regarding the EEG, whether it is covered by health insurance can depend on your specific plan. In many cases, if the test is deemed medically necessary by your physician, it may be partially covered. The out-of-pocket cost can vary widely, but it typically ranges from $200 to $1,000 depending on the facility and whether you have insurance coverage.

Specialist Recommendations
In the Kaohsiung-Pingtung area, you may want to consult a neurologist or a specialist in infectious diseases. Hospitals such as Kaohsiung Medical University Hospital or Pingtung Christian Hospital may have specialists who can provide further evaluation and guidance. It is advisable to call ahead and inquire about their experience with prion diseases and whether they can assist with your specific concerns.

Conclusion
While your symptoms are concerning, it is essential to approach this situation with a comprehensive perspective. Many conditions can cause headaches and memory issues, and vCJD is extremely rare. I recommend scheduling an appointment with a neurologist to discuss your symptoms in detail and to determine the most appropriate tests. Early intervention and thorough evaluation are key to addressing your health concerns effectively.

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