SGLT2 inhibitors and risk of distant metastasis in patients with breast cancer and type 2 diabetes: a target trial emulation with biological plausibility analysis.

Creutzfeldt-Jakob disease (CJD) is a rare and lethal neurodegenerative disease with rapid progression (, ). The most common type is chronic or subacute spongiform encephalopathy with dementia, psychiatric disorders, and Parkinsonian-like manifestations due to prion infection (). The lack of a cure or mitigation for this disease and the fact that its course may mimic multiple diseases makes differential diagnosis extremely important. Anti-NMDA receptor encephalitis is an auto-immune disease associated with anti-NMDA receptor anti-bodies, usually associated with ovarian teratomas (, ). Although symptoms of anti-NMDA receptor encephalitis are usually severe, early diagnosis and treatment can help patients achieve a better outcome and prognosis (). Creutzfeldt-Jakob disease (CJD) and anti-NMDA receptor encephalitis are two different neurological diseases that usually require a combined evaluation of various indicators to differentiate them, including laboratory tests, neuroimaging, and electroencephalography (EEG). There is some overlap between the symptoms and imaging manifestations of anti-NMDAR encephalitis and CJD, which can be easily confused in clinical practice. Because the rate of progression and prognosis of the two conditions differ greatly, a rapid differentiation is needed. Therefore, this study aimed to better characterize the differences in clinical indicators of anti-NMDAR encephalitis and CJD, especially EEG, which can provide an important reference for the diagnosis and differential diagnosis of these two disorders. By retrospective analysis of patients with CJD and anti-NMDAR encephalitis, we described EEG manifestations of CJD and anti-NMDA receptor encephalitis and their differences. We selected patients who attended the Department of Neurology, Zhongshan Hospital, Xiamen University, between November 1, 2011 and March 1, 2022, who were diagnosed with CJD or anti-NMDA receptor encephalitis. These patients underwent continuous video EEG monitoring (every patient in our study received standardized 2-h EEG recordings with no extended monitoring sessions and all the EEG recordings were obtained before initiation of treatment), lumbar puncture cerebrospinal fluid examination, and cranial magnetic resonance imaging (MRI) at least once during their hospitalization. A retrospective clinical study was conducted by collecting their data. Their clinical characteristics including gender, age, pre-treatment modified Rankin Scale (mRS) scores, seizures, ancillary findings and EEG characteristics were extracted from hospital records and retrospectively analyzed. This study was approved by the Ethics Committee of Zhongshan Hospital, Xiamen University, and was conducted in accordance with the latest version of the Declaration of Helsinki. All operations in this study followed the principle of informed consent.