The Intractable Puzzle of Sporadic Creutzfeldt-Jakob Disease in Very Young People

In the era of randomized controlled trials and multicenter observational studies, it is easy for academic neurology to overlook the compelling questions posed by individual patient cases. Sporadic Creutzfeldt-Jakob disease (sCJD) in a 21-year-old patient was the right diagnosis, but hardly a satisfactory explanation for either the doctor or patient and his family in the Clinical/Scientific Note by Appleby et al.1 in this week's issue of Neurology® . How can a typically late-onset disorder occur in someone so young?