lewy body dementia

Question 1

what are features of lewy body dementia?

Answer 1

1. parkinsonism
2. visual hallucinations - or delusions, non-visual hallucinations
3. progressive cognitive impairment
   - before parkinsonism, usually within a year of each other
   - fluctuating cognition
   - early impairments in attention + executive function rather than just memory loss

Question 2

how is LBD diagnosed?

Answer 2

usually clinical

SPECT/DaTscan

Question 3

what is the characteristic pathological features of LBD?

Answer 3

lewy bodies (alpha-synuclein cytoplasmic inclusions) in the substantia nigra, paralimbic + neocortical areas

Question 4

what is the management of LBD?

Answer 4

acetylcholinesterase inhibitors (donepezil, rivastigmine) + memantine (NMDA antagonist) can be used

avoid neuroleptics (antipsychotics) - can develop irreversible parkinsonism

Question 5

what are parkinsonism features?

Answer 5

tremor- pin-rolling resting tremor
bradykinesia
rigidity
postural instability