Brain stem lesions in sporadic Creutzfeldt-Jakob disease: a histopathological and immunohistochemical study.

Lesions of the brain stem in sporadic CJD were histopathologically and immunohistochemically investigated using an anti-PrP antibody on ten consecutive autopsy cases. Three major histopathological changes, spongiform changes, neuronal loss and hypertrophic astrocytosis, were employed as parameters of the alterations. The quadrigeminal plate and pontine nuclei were the most severely and consistently affected structures, and immunoreactivity against PrP was seen in these structures. There existed some discrepancies between the severity of the lesions and the intensity of the immunoreactivity against PrP. The medulla oblongata essentially remained normal on histopathological examination, but the inferior olivary nucleus showed prominent PrP deposition. Although the general view that pathological alterations in the brain stem are relatively mild in sporadic CJD was confirmed in this study, lesions of variable degrees which might influence a patient's clinical course were still observed in many structures in the brain stem.