Cerebrospinal fluid analysis to exclude infections such as tertiary syphilis or subacute sclerosing panencephalitis is recommended. Toxicity from bismuth, bromides, and lithium must be ruled-out. Myoclonus is usually more prominent early in toxic/metabolic disorders than in Creutzfeldt-Jakob disease, and seizures in CJD are usually late 1)
1)
Johnson RT, Gibbs CJ. Creutzfeldt-Jakob Disease and Related Transmissible Spongiform Encephalopathies. N Engl J Med. 1998; 339:1994– 2004