TRC: Lewy body dementia

Lewy body dementia

Lewy body dementia has clinical features that are similar to both Alzheimer's disease and Parkinson's disease. It was for this reason that it remained a hidden illness until being described in the mid 80's. Therefore the slide indicates those features that differentiate Lewy body dementia from the other two illnesses. The Lewy bodies that are found throughout the cortex and midbrain of patients lead to prominent loss of memory and executive functioning.

The severity of these symptoms fluctuates and includes episodes of pseudodelirium. Prominent psychotic symptoms occur early in the illness. However, treatment with antipsychotic agents doubles the rate of cognitive decline and halves the life span of patients with Lewy body dementia. Acutely, patients can manifest severe akinesia, dystonias and neuroleptic malignant syndrome (NMS).

Treatment of Lewy body dementia associated hallucinations with haloperidol can lead to all the following EXCEPT:

Extra info: Lewy body dementia patient's response to haloperidol can be quite dramatic and requires withdrawal of the offensive agent.

Option explanation:

acute extrapyramidal symptoms

cognitive decline

depressive symptoms

decreased life span

A practical diagnostic tool for Lewy body dementia includes seeing the clinical response to:

Extra info: Although patients with Lewy body dementia often have a dramatic severe reaction to antipsychotics that would confirm your diagnosis, you can not put your patient at that risk. Otherwise, patient's responses to AChE inhibitors are not that different from patients with other dementias. Finally, a dramatic response to the levodopa/carbidopa combination would indicate the patient had Parkinson's.

Option explanation:

antipsychotics

acetylcholinesterase inhibitors

levodopa/carbidopa

none of the above

Lewy body dementia

Lewy body dementia

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