Dementia with lewy bodies

Question 1

What is dementia w/ lewy bodies?

Answer 1

Neurodegenerative proteinopathy (alpha synuclein)

Late onset dementia

Question 2

Pathophysiology of dementia with lewy bodies?

Answer 2

Widespread neuronal loss, surviving neurons contain lewy bodies

Components of lewy bodies include: Alpha-synuclein aggregates- insoluble- cell dysfunction- cell damage

Disruption of cholinergic and dopaminergic pathways

Question 3

Presentation of dementia with lewy bodies?

Answer 3

Fluctuating cognition
+
Recurrent well-formed visual hallucinations
+/-

• Presence of extrapyramidal features
• Additional- neuroleptic sensitivity

Question 4

Investigation of dementia with lewy bodies?

Answer 4

DaT (Dopamine transport imaging)
(not essential for diagnosis)

CLINICAL DIAGNOSIS

Question 5

Treatment of dementia with lewy bodies?

Answer 5

Small dose levodopa/decreased acetylcholine- Trial cholinesterase inhibitors

Support PD nurse specialist

Question 6

Core criteria of dementia with lewy bodies?

Answer 6

• Fluctuating cognition plus
• Well formed visual hallucinations +/-
• Presence of extrapyramidal features