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Dementia with Lewy Bodies

Dementia with Lewy Bodies is an interesting form of Dementia that has similar symptoms as Parkinson’s disease and Alzheimer’s disease.

This condition can also be known as Lewy Body Dementia.

“Lewy bodies” are the typical findings in this form of Dementia. They are found as proteins (alpha-synuclein) in neurons of the brain – often detected on autopsy.

Affected neurons in the brain are “cholinergic neurons” and “dopaminergic neurons“.

Cholinergic neurons are affected by Alzheimer’s.

Dopaminergic neurons are affected by Parkinson’s.

A large sensitivity to medications related to neuroleptic and antiemetic medications.

Often symptoms start with Dementia with Lewy Bodies, when the patient notices that their body won’t respond as well as it used to. This will often continue to worsen over time. Approximately a year later, there is a change in memory and problems with critical thinking. Hallucinations can soon follow thereafter.

Some medications can worsen symptoms:

1.)  Thioridazine
2.)  Chlorpromazine
3.)  Haloperidol

Symptoms

–  Loss of attention
–  Memory changes
–  Vision changes
–  Hallucinations
–  Gait shuffling
–  Blank facial expression
–  Movements become more rigid
–  Falling

Causes

–  Not well understood
–  Genetics may be associated

Management/Treatment

There is no cure for this disease – but management is important

  –  Cabidopa + Levodopa (Sinemet)

Cholinesterase inhibitors

  –  Donepezil (Aricept)
  –  Rivastigmine (Exelon)
  –  Galantamine (Reminyl)

Atypical Antipsychotics

Other medications

  –  Botulinum toxin
  –  Clonazepam

Management

–  Over time the need for additional supervision is necessary
–  Whether it is family members or nursing homes
–  Individuals will have good and bad days
–  Maintain schedule
–  Changes may cause relapses or worsening symptoms for that day or period