Lewy body dementia
What is Lewy Body Dementia?
ALewy Body Dementia (LCD) or Lewy Body Disease is a rare, degenerative disease that occurs by accumulation of so-called Lewy bodies in neurons of the central nervous system, leading to various progressive symptoms related to cognition and movement.
Lewy Body Dementia thus leads to symptoms of dementia and parkinsonism simultaneously.
parkinsonismis the set of symptoms characterized by:
Bradykinesia (slowness of movement), associated with muscle rigidity and/or tremor.
So, do not confuse: parkinsonism is the set of symptoms. When we talk about Parkinson's disease, we are talking about a disease, which also has parkinsonism.
In Dementia by Lewy Bodies, there are, in addition to parkinsonism, other characteristics that help to differentiate from Parkinson's Disease, such as early dementia, hallucinations, falls and behavioral changes.
Lewy Body DementiaIt is rare and therefore very difficult to diagnose. It is almost always diagnosed as Parkinson's or Alzheimer's disease. Interestingly some are diagnosed as having "Parkinson's or Alzheimer's at the same time."
What are the symptoms of Dementia Lewy Bodies?
The main symptoms of Lewy Body Dementia are:
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Parkinsonism, which is Slowness of movement associated with stiffness or tremor. Due to the presence of Parkinsonism, many times the patient with Lewy can be mistakenly diagnosed with Parkinson's disease.
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Insanity, which is the impairment of cognitive functions, leading to memory impairment, forgetfulness, change in planning, with difficulty performing simple tasks that were previously performed automatically.
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hallucinations, which may only be sporadic, but which more commonly occur through visual hallucinations, with animals or people.
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behavior change, with an appearance of restlessness, impatience, and may have aggressiveness and impulsive behavior.
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Hypersensitivity to antipsychotic drugs: since behavior change is common, the use of antipsychotic medications by physicians is common. However, the patient with D. Lewy can have an exacerbated reaction and become "doped" in front of low doses of medication, or else become more agitated or worsen the hallucinations with the increase in medication.
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Fluctuations: The symptoms have the characteristic of being fluctuating, with good times and, suddenly, sudden and recurrent changes with the symptoms described above.
How is Lewy Body Dementia diagnosed?
ALewy Body Dementia It is mainly diagnosed throughpresence of symptomsdescribed above, or part of them, associated with the exclusion of other causes, such as reversible dementias.
Imaging tests, such as an MRI scan, are helpful, but by themselves they almost never diagnose dementia with Lewy bodies. SPECT examination (scintigraphy) with Trodat can be useful, but it does not serve to differentiate DCL from other forms of parkinsonism, such as Parkinson's Disease.
In the face of diagnostic doubt, thePET-CT, is useful and can assess the difference in metabolism, which in DLB is smaller in the occipital region of the brain.