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Dear Editor, A 53-year-old male patient was admitted to our hospital with symptoms of imbalance lasting 15 days. It was learned that his symptoms had increased within days and led to further deterioration in his walking. His medical history was normal except for hypertension. On neurologic examination, pursuit and saccadic eye movements were impaired, and cerebellar dysarthria was present. Muscle strength was normal. Cerebellar tests were bilaterally impaired, evident on the left. He had a wide-based gait and truncal ataxia. Tandem gait was impaired, and the Romberg test was positive. Cranial magnetic resonance imaging (MRI) revealed gyral signal increase at the bilateral head of the putamen and caudate nucleus, and at bilateral cerebral cortical areas and bilateral cerebellum, more evident at the right parieto-occipital region in diffusion-weighted and fluid-attenuated inversion recovery sequences (Figures 1, 2). Cerebrospinal fluid (CSF) biochemistry and cell count were within normal limits. During follow-up, a significant worsening of the cerebellar findings was observed within two weeks. He had severe dysarthria, and his truncal ataxia became prominent. There was no myoclonus. Akinetic mutism developed three weeks after the onset of the symptoms. The patient, fed with a nasogastric tube, became bedridden. Diffuse slow background activity was observed in the electroencephalography (EEG). Periodic sharp wave complexes

Sporadic Creutzfeldt-Jakob Disease with Isolated Cerebellar Findings at Onset