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Dementia With Lewy Bodies, Lewy
Body Dementia
Dementia with Lewy bodies, the
second most frequent cause of
dementia in elderly adults, is a
neurodegenerative disorder
associated with abnormal structures
(Lewy bodies) found in certain areas
of the brain. Because these
structures and many of the symptoms
of dementia with Lewy bodies are
associated with Parkinson's and
Alzheimer's diseases, researchers do
not yet understand whether dementia
with Lewy bodies is a distinct
clinical entity or perhaps a variant
of Alzheimer's or Parkinson's
disease. Recent research has
revealed that Lewy bodies contain
deposits of a protein called alpha-synuclein
that is also linked to Parkinson's
disease and multiple system atrophy.
Symptoms can range from traditional
parkinsonian effects, such as loss
of spontaneous movement (bradykinesia),
rigidity (muscles feel stiff and
resist movement), tremor, and
shuffling gait, to effects similar
to those of Alzheimer's disease,
such as acute confusion, loss of
memory, and loss of, or fluctuating,
cognition. Visual hallucinations may
be one of the first symptoms noted,
and patients may suffer from other
psychiatric disturbances such as
delusions and depression. Onset of
the disorder usually occurs in older
adults, although younger people can
be affected as well. In 1996
scientists published guidelines for
the diagnosis of dementia with Lewy
bodies (McKeith IG, et al,
Neurology, vol 47, pp 1113-1114, Nov
1996).
Treatment
Scientists continue to search for a
specific course of therapy for
people with dementia with Lewy
bodies. Treatment is symptomatic,
often involving the use of
medication to control the
parkinsonian and psychiatric
symptoms. However, patients should
be aware that antiparkinsonian
medication that may help to reduce
tremor and loss of muscle movement
may actually worsen such symptoms as
hallucinations and delusions.
Similarly, neuroleptic drugs
prescribed for psychiatric symptoms
may in fact markedly worsen the
movement symptoms. In general
atypical antipsychotic medications
are more successful than older drugs
such as haloperidol.
Prognosis
Dementia with Lewy bodies is a
slowly progressive condition for
which there is no cure.
Content Courtesy : www.ninds.nih.gov
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