|Dementia with Lewy bodies
|Creutzfeldt Jakob disease
| Huntington's Disease/Chorea
|Anti Dementia Drugs
|AIDS Dementia Complex
|Normal Pressure Hydrocephalus
|Mental Capacity Act 2005
|Behavioural and Psychological Symptoms of Dementia
|Abbreviated Mental Test Score (AMTS)
There are reports of a Lewy Neuritis in the CA2 region of the hippocampus which may be unique to DLB
- Parkinsonism Limited L-Dopa responsive
- Oversensitivity to neuroleptic drugs
- Lewy bodies are also found in the cortex and subcortex but are not specific to DLB
- Lewy bodies are intracytoplasmic inclusions composed of ubiquitin, parkin and alpha-synuclein
- Lewy body and Alzheimer pathology often seen together e.g. senile plaques
- Fluctuating levels of cognition, Bizarre often complex delusions
- Vivid detailed visual hallucinations which may cause agitation but not always.
- Symmetrical Parkinsonism, Aphasia and apraxias
- REM Sleep disturbance - loss of normal paralysis with dreaming
- Tendency to episodes of delirium and sensitivity to neuroleptics
- FBC, U&E, ESR, CRP, LFT, TFT B12 folate, ECG, CXR
- MRI or CT shows generalised atrophy
- REM Sleep disturbance
- Idiopathic Parkinson's disease - medications can cause hallucinations and delirium especially anticholinergics
- Parkinsonism can respond to L-Dopa or DA agonists. The response can be poor and risk of worsening Visual hallucinations/Confusion. Use cautiously. Stop if no improvement.
- Cholinesterase inhibitors can be trialled and may help.
- Neuroleptics may be used cautiously for psychosis e.g. Quetiapine.
- Clonazepam at bedtime for sleep disorder.
- Treat depression e.g. sertraline, citalopram