- A common cause of dementia (5-10% of cases).
- Although it shares features of both alzheimer’s disease and parkinson’s disease, it is a seperate entity with a different course.
- Dementia with relative sparing of short-term memory
- Parkinsonism (bradykinesia, rigidity, tremor)
- Cognitive decline- often fluctuating and may seem to improve and regress
- Complex visual hallucinations (aliens/faces)
- Often concomitant depression too.
- Recurrent falls/syncope
- Also, REM sleep disorder/restless leg syndrome
- DAT (dopamine) scan (SPECT)
- (MIBG scan may also be useful)
- Lewy bodies are eosinophilic intracytoplasmic neuronal inclusions of abnormally phosphorylated neurofilament proteins aggregated with ubiquitin and alpha-synuclein. They seem to cause decreased ACh transmission in the brain.
- Lewy neurites (ubiquitin and alpha-synuclein neuritic degeneration), Alzheimer’s change and vascular change may all be present too.
- Rivastigmine (anticholinesterase drug) may be beneficial
- IMPORTANT- a feature of Lewy body dementia is the hypersensitivity to neuroleptic drugs. If there is suspicion about Lewy-body dementia, the patient must be closely monitored while these drugs are given. Avoid neuroleptic treatment if possible.