Lewy Body Disease
(Lewy Body Dementia; Dementia with Lewy Bodies)
Definition
Dementia is the progressive loss of memory and various other mental functions, including the ability to:
- Learn
- Reason
- Judge
Lewy body disease is caused by the build up of Lewy bodies. These are abnormal protein deposits inside brain cells that control certain aspects of memory and motor control. It is the second most common type of progressive dementia.
Brain Cells
Causes
It is not clear exactly what causes the build up of Lewy bodies in the brain. But, Lewy body disease is linked to:
- Parkinson's disease
- Multiple system atrophy
- Other disorders
Risk Factors
These factors increase your chance of developing Lewy body disease. Tell your doctor if you have any of these risk factors:
- Gender: male
- Age: 53-83 years
- Family history of Lewy body disease
Symptoms
Lewy body disease is characterized by:
-
Fluctuations in alertness and attention
- Frequent drowsiness
- Lethargy
- Staring into space
- Disorganized speech
- Insomnia
- Recurrent visual hallucinations
- Poor regulation of body temperature and blood pressure
- Obsessive compulsive behaviors
- Forgetfulness
-
Parkinsonian motor symptoms
- Rigidity
- Loss of spontaneous movement
- REM behavior disorder
Diagnosis
The only way to diagnose Lewy body disease conclusively is through an autopsy . But, a doctor can do tests to narrow the cause of dementia. You will be asked about your symptoms and medical history. The doctor will do a physical exam as well as other tests, such as:
Treatment
While there is no cure, there are treatments that can control the symptoms. Talk with your doctor about the best treatment plan for you. Treatment options include:
Medications
These medications may be used to help with the symptoms:
- Donepezil and rivastigmine —to help with cognition; may worsen motor symptoms
- Levodopa—to help control rigidity and loss of spontaneous movement
- Antidepressants
- Anticonvulsants
If you have Lewy body disease, you may be particularly sensitive to medications called neuroleptics. You may have adverse events with these medications.
RESOURCES:
Lewy Body Dementia Association
http://www.lewybodydementia.org/
National Institute of Neurological Disorders and Stroke
http://www.ninds.nih.gov/
CANADIAN RESOURCES:
Alzheimer Society
http://www.alzheimer.ca/
Canadian Stroke Network
http://www.canadianstrokenetwork.ca/
References:
Ballard CG, Chalmers KA, Todd C, McKeith IG, O'Brien JT, Wilcock G, et al. Cholinesterase inhibitors reduce cortical Abeta in dementia with Lewy bodies. Neurology . 2007;68:1726-1729.
Bouchard RW. Diagnostic criteria of dementia [review]. Can J Neurol Sci . 2007;34:(Suppl 1)S11-18.
Camicioli R, Gauthier S. Clinical trials in Parkinson's disease dementia and dementia with Lewy bodies [review]. Can J Neurol Sci . 2007;34:(Suppl 1)S109-117.
Carson-DeWitt R. Dementia. EBSCO Health Library website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=15topicID=81 . Updated November 2008. Accessed February 6, 2009.
Chaudry, A, Khan, F. Dementia with Lewy bodies. In: Gilman S, ed. MedLink Neurology. San Diego, CA: MedLink Corporation. Available at: http://www.medlink.com . Accessed August 10, 2007.
Chou KL, Borek LL, Friedman JH. The management of psychosis in movement disorder patients [review]. Expert Opin Pharmacother . 2007;8:935-943.
Dementia with Lewy bodies information page. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/dementiawithlewybodies/dementiawithlewybodies.htm . Accessed June 25, 2007.
Goldmann Gross R, Siderowf A, Hurtig HI. Cognitive impairment in Parkinson’s disease and dementia with Lewy bodies: a spectrum of disease. Neurosignals . 2008;16:24-34.
Kemp PM, Hoffmann SA, Tossici-Bolt L, Fleming JS, Holmes C. Limitations of the HMPAO SPECT appearances of occipital lobe perfusion in the differential diagnosis of dementia with Lewy bodies. Nucl Med Commun . 2007;28:451-456.
Lewy body disease: LBD. Lewy Body Disease Association website. Available at: http://www.lewybodydementia.org/docs/brochure/3_brochure.pdf . Accessed June 25, 2007.
Tarawneh R, Galvin JE. Distinguishing Lewy body dementias from Alzheimer’s disease. Expert Review of Neurotherapeautics. 2007;7:1499-1516.
Weintraub D, Hurtig HI. Presentation and management of psychosis in Parkinson’s disease and dementia with Lewy bodies. Am J. Psychiatry . 2007;164:1491-1498.
Last reviewed January 2009 by Rimas Lukas, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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