- Dementia with Lewy bodies - causes
- Dementia with Lewy bodies - symptoms
- Dementia with Lewy bodies - diagnosis
- Dementia with Lewy bodies - treatment
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Dementia with Lewy bodies is a difficult disease to recognize. It can be misdiagnosed by some as Alzheimer's, Parkinson's, or other neurodegenerative disease, and therefore not treated properly. What are the causes and symptoms of dementia with Lewy bodies? What is the treatment? How to distinguish them from other dementia diseases?
Dementia with Lewy bodies(dementia with Lewy bodies - DLB) is a neurodegenerative disease, i.e. a disease in the course of which pathological changes occur in the central nervous system, resulting in there is dementia (dementia).
For dementia with Lewy bodies, the most characteristic are mental symptoms - visual hallucinations, delusions, depression.
Dementia with Lewy bodies - causes
- recurrent, detailed and highly plastic visual hallucinations (less often auditory or other)
- delusions
- mood disorders, depression
- REM sleep behavior disorder
Hypersensitivity reaction to administration of typical antipsychotic drugs is also characteristic. After using them, the symptoms of parkinsonism worsen.
Dementia with Lewy bodies results from the build up of abnormal protein deposits in the brain, which we call Lewy bodies. They cause damage to brain cells, which causes disease symptoms.
Lewy bodies are characteristic not only of the described dementia. They are also seen in many other neurodegenerative diseases, such as Parkinson's disease.
However, in DLB, Lewy bodies are found in the neocortex and in the limbic system, rather than predominating in the brainstem - as in Parkinson's disease.
Dementia with Lewy bodies - symptoms
- dementia - in this case these are cognitive disorders of varying severity - in the early stage of the disease, concentration, executive and visual-spatial disorders dominate without deterioration of short-term memory
- parkinsonian syndrome - in this case it is mainly characterized by akinesia, i.e. immobility, complete numbness, there is also noticeable movement slowdown and a masked face, expressionless, less frequent resting tremors, characteristic of Parkinson's disease,importantly - parkinsonian syndrome appears simultaneously with dementia or slightly later (at an interval of no more than a year)
Dementia with Lewy bodies (DLB) and Alzheimer's disease (AD)
- Both Alzheimer's disease and Lewy body dementia have similar symptoms. In both of these conditions, symptoms may begin subtly and progress over the years. In both cases, there are difficulties with concentration, then memory problems, accompanied by visual-spatial disturbances, the patients are apathetic. […] It should be emphasized that the patient has problems with both logical and abstract thinking, as well as with solving everyday problems. However, memory impairment in DLB is milder and occurs generally later than in Alzheimer's disease. In terms of movement disorders, the opposite is true - in DLB, episodes of movement disorders occur at an earlier stage than in Alzheimer's disease. Fainting, falls, and disturbed consciousness also occur more frequently in DLB than in AD. Tremor also occurs in DLB, which, unlike Parkinson's disease, is symmetrical, which may be a distinguishing feature. Visual hallucinations are also characteristic of dementia with Lewy bodies. They occur in up to about 80 percent. sick.
Dementia with Lewy bodies - diagnosis
Symptoms and neuropsychological tests (to assess cognitive function) play an important role in the diagnosis of dementia with Lewy bodies.
Neuroimaging tests (e.g. magnetic resonance imaging, computed tomography) and laboratory tests are auxiliary tests.
The diagnosis is confirmed byanatomopathological examination(examination of changes in the structure of tissues and organs - in this case the tissues of the brain - caused by disease).
Dementia with Lewy bodies - treatment
1) Drug treatment
The patient is given acetylcholinesterase inhibitors, similar to Alzheimer's disease. There are 3 acetylcholinesterase inhibitors:
- donepezil hydrochloride
- rivastygmina
- galantamine
However, they are not always effective and well tolerated by patients, so other drugs are sought after. Recently, there has been increasing interest in the use of memantine. This drug works a bit differently than acetylcholinesterase inhibitors - it can improve mental and memory processes and allow the patient to perform simpler daily activities, such as washing or eating. It also brings improvement in the field of behavioral disorders inREM sleep phase.
Dementia with Lewy bodies is considered by some to be the second most common cause of dementia (after Alzheimer's disease).
Levodopa (the basic drug in Parkinson's disease) is used in the treatment of parkinsonian syndrome, but due to the possibility of exacerbation of psychotic symptoms after its administration, the lowest effective doses of this drug are used.
The therapy also includes antipsychotics, but hypersensitivity reactions may occur after them, so in this case they should also be used with caution.
During the treatment of depression symptoms in patients with dementia with Lewy bodies, it is recommended to use drugs belonging to the group of selective serotonin reuptake inhibitors and others, such as mirtazapine, venlafaxine. He althcare professionals advise you to avoid tricyclic antidepressants.
2) Non-pharmacological treatment
Cognitive stimulation, reality orientation therapy, memory training, working with the calendar, clock, photo albums, arranging puzzles, solving crosswords may be helpful.
Worth knowingDementia with Lewy bodies (DLB) and Parkinson's disease
Dementia with Lewy bodies from dementia in the course of Parkinson's disease allows to distinguish the so-called one year criterion. It means that if parkinsonian symptoms and dementia appear together in the first year of illness, then Lewy body dementia can be diagnosed. If dementia joins parkinsonian symptoms after more than a year, the diagnosis is Parkinson's disease.
About the author
Monika Majewska A journalist specializing in he alth issues, especially in the areas of medicine, he alth protection and he althy eating. Author of news, guides, interviews with experts and reports. Participant of the largest Polish National Medical Conference "Polish woman in Europe", organized by the "Journalists for He alth" Association, as well as specialist workshops and seminars for journalists organized by the Association.
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