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Lewy Body Disease(Lewy Body Dementia; Dementia with Lewy Bodies)
Definition

Lewy body disease is a type of dementia. Dementia is the progressive loss of memory and various other mental functions, including the ability to learn, reason, and judge.

Brain Cells

Neurons

Copyright © Nucleus Medical Media, Inc.

Causes

Lewy body disease is associated with the build up of Lewy bodies in regions of the brain. These are abnormal protein deposits inside cells that play a role in certain aspects of memory, visual processing, and and motor control. It is not clear exactly what causes the build up of Lewy bodies in the brain.

Risk Factors

Lewy body disease is more common in men, and in people over 50 years old. It is also more common in people with a family history of Lewy body disease, Parkinson's disease, or other dementias.

The disease is linked to:

Symptoms

Lewy body disease is characterized by:

  • Fluctuations in alertness and attention—frequent drowsiness, lethargy, staring into space, disorganized speech, and insomnia
  • Recurrent visual hallucinations
  • Poor regulation of body temperature and blood pressure
  • Obsessive compulsive behaviors
  • Forgetfulness
  • Parkinsonian motor symptoms, such as rigidity or loss of spontaneous movement
  • REM sleep behavior disorder
Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. A doctor can do tests to narrow the cause of dementia. Other tests may include:

  • Memory, language, and other cognitive tests
  • Neuropsychological tests
  • Patient and family interviews
  • Imaging tests take pictures of internal bodily structures. This can be done with:
  • Blood tests

The only way to confirm Lewy body disease is through an autopsy.

Treatment

While there is no cure for Lewy body disease, there are treatments that can control the symptoms. Talk with your doctor about the best treatment plan for you. Treatment options include:

Medications

These medications may be used to help with the symptoms:

  • Cholinesterase inhibitors
  • Glutamate blockers
  • Catecholamines
  • Antidepressants
  • Anticonvulsants

If you have Lewy body disease, you may be sensitive to medications called neuroleptics. You may have adverse events with these medications.

Other Treatments

You may benefit from:

Prevention

There are no current guidelines to prevent Lewy body disease.

RESOURCES:

Lewy Body Dementia Association
http://www.lewybodydementia.org

National Institute of Neurological Disorders and Stroke
http://www.ninds.nih.gov

CANADIAN RESOURCES:

Alzheimer Society
http://www.alzheimer.ca

Canadian Stroke Network
http://www.canadianstrokenetwork.ca

References:

An introduction to Lewy body dementia. Lewy Body Disease Association website. Available at: http://lbda.org/content/intro-to-lbd. Accessed August 15, 2014.

Ballard CG, Chalmers KA, Todd C, et al. Cholinesterase inhibitors reduce cortical Abeta in dementia with Lewy bodies. Neurology. 2007;68:1726-1729.

Bouchard RW. Diagnostic criteria of dementia [review]. Can J Neurol Sci. 2007;34:(Suppl 1)S11-18.

Camicioli R, Gauthier S. Clinical trials in Parkinson's disease dementia and dementia with Lewy bodies [review]. Can J Neurol Sci. 2007;34:(Suppl 1)S109-117.

Chou KL, Borek LL, Friedman JH. The management of psychosis in movement disorder patients [review]. Expert Opin Pharmacother. 2007;8:935-943.

Dementia with Lewy bodies. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 18, 2014. Accessed August 15, 2014.

Dementia with Lewy bodies information page. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/dementiawithlewybodies/dementiawithlewybodies.htm. Updated May 22, 2014. Accessed August 15, 2014.

Emre M, Tsolaki M, Bonnucelli U, et al. Memantine for patients with Parkinson’s disease dementia or dementia with Lewey bodies: a randomised, double-blind, placebo controlled trial. Lancet Neurol. 2010;9(10):969-77.

Goldmann Gross R, Siderowf A, Hurtig HI. Cognitive impairment in Parkinson’s disease and dementia with Lewy bodies: a spectrum of disease. Neurosignals. 2008;16:24-34.

Jellinger KA. Formation and development of Lewy pathology: a critical update. J Neurol. 2009;256(Suppl 3):270-279.

Kemp PM, Hoffmann SA, Tossici-Bolt L, Fleming JS, Holmes C. Limitations of the HMPAO SPECT appearances of occipital lobe perfusion in the differential diagnosis of dementia with Lewy bodies. Nucl Med Commun. 2007;28:451-456.

Meeus B, et al. The genetics of dementia with Lewy bodies: what are we missing? Arch Neurol. 2012;69(9):1113-8.

Tarawneh R, Galvin JE. Distinguishing Lewy body dementias from Alzheimer’s disease. Expert Review of Neurotherapeautics. 2007;7:1499-1516.

Weintraub D, Hurtig HI. Presentation and management of psychosis in Parkinson’s disease and dementia with Lewy bodies. Am J Psychiatry. 2007;164:1491-1498.



Last reviewed August 2014 by Rimas Lukas, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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