Tricaprin is Not a Treatment for Creutzfeldt-Jakob Disease
There is no evidence that tricaprin (or any other glyceryl triester) has any role in treating Creutzfeldt-Jakob disease (CJD), and it should not be used for this indication. CJD remains a uniformly fatal prion disease with no curative treatment available 1.
What Tricaprin Actually Is
Tricaprin is a glyceryl triester (triglyceride) used exclusively as a cosmetic ingredient, functioning as an occlusive skin-conditioning agent and nonaqueous viscosity-increasing agent in cosmetic formulations 2. It has been evaluated for safety in dermatological applications at concentrations up to 46% in cosmetic products, but has no established medical therapeutic use 2.
Current Management of Creutzfeldt-Jakob Disease
No Disease-Modifying Therapy Exists
- CJD is a rapidly progressive, uniformly fatal neurodegenerative prion disease characterized by cognitive dysfunction, motor disorders, and behavioral abnormalities 1.
- Management focuses entirely on supportive care and symptom palliation, as no cure or disease-modifying treatment currently exists 1.
- The disease typically progresses rapidly to death, with most patients surviving only months after diagnosis 1, 3.
Symptomatic Management Approach
For seizures (if they occur):
- Administer benzodiazepines (lorazepam) as first-line treatment for active seizures 4.
- Use levetiracetam, sodium valproate, phenytoin, propofol, or barbiturates as second-line agents for refractory seizures 4.
- For myoclonic seizures specifically, propofol is particularly effective, along with clonazepam, sodium valproate, or levetiracetam 4.
For agitation or behavioral disturbances:
- Consider propofol for severe agitation requiring immediate intervention (2 mg/kg bolus followed by 3-4 mg/kg/hr infusion) 5.
- Avoid high-dose glucocorticoids, as they are associated with higher mortality in severe brain injury 4.
For supportive care:
- Focus on comfort measures, pain management, and maintaining quality of life 1.
- Provide appropriate end-of-life care as the disease progresses 1.
Critical Infection Control Considerations
Strict precautions are mandatory:
- Brain tissue, cerebrospinal fluid, and ocular tissues are highly infectious and require stringent containment or incineration 3.
- All surgical instruments must undergo stringent sterilization procedures, as prions are extremely difficult to eradicate 3.
- Patients with known or suspected CJD should never be considered as donors for any tissues or biological products 3.
- Healthcare workers require specific preventive measures due to possible occupational transmission 3.
Diagnostic Approach (Not Treatment)
- MRI demonstrating restricted diffusion in neocortical areas and deep nuclei is characteristic 6.
- CSF biomarkers showing abnormal levels of 14-3-3 protein, total-tau, and positive prion seeding activity (RT-QuIC) establish diagnosis 6.
- EEG may reveal pseudoperiodic discharges, though sleep architecture is progressively destroyed as disease advances 7.
- FDG-PET may show glucose hypometabolism patterns that can mimic other dementias, requiring integration of multimodal imaging and fluid biomarkers for accurate diagnosis 6.