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Onset of Vulvodynia in a Woman Ultimately Diagnosed With Creutzfeldt-Jakob Disease

Reichman, Orna MD1; Tselis, Alexandros MD2; Kupsky, William J. MD3; Sobel, Jack D. MD1

Obstetrics & Gynecology:
doi: 10.1097/AOG.0b013e3181b80294
Case Reports
Abstract

BACKGROUND: Vulvodynia, defined as vulvar pain or burning in the presence of normal vulvar appearance, is common and is associated with chronic pain syndromes and psychiatric disorders.

CASE: A postmenopausal woman complained of vulvar burning. Causes for vulvar burning including yeast infection, estrogen deficiency, and contact dermatitis were excluded. Vulvovaginal examination was normal. Subsequently, she complained of headaches, insomnia, and depression. She developed ataxic gait with rapidly progressive dementia. Brain biopsy confirmed the diagnosis of Creutzfeldt-Jakob disease, and 3 weeks later she lapsed into coma and died.

CONCLUSION: This report is unique in that a rare disease, known to result in neuronal damage, mimicked symptoms of vulvodynia in its initial phase. This supports the hypothesis that vulvodynia is a neuropathic syndrome originating in the nervous system.

In Brief

Recent onset of vulvodynia in a woman ultimately diagnosed with Creutzfeldt-Jakob disease supports the hypothesis that vulvodynia is a neuropathic syndrome resulting from neuronal damage.

Author Information

From the 1Division of Infectious Diseases, 2Department of Neurology, and 3Department of Pathology, Wayne State University School of Medicine, Detroit, Michigan.

Corresponding author: Jack Sobel, MD, Division of Infectious Diseases, Harper Hospital, 3990 John R Street, Detroit MI 48201; e-mail: jsobel@med.wayne.edu.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2010 The American College of Obstetricians and Gynecologists