Lewy Body Dementia ☺️

Question 1

Epidemiology

Pathophysiology

Answer 1

3rd most common dementia

-Lewy bodies in substancia nigra, paralimbic, neocortical areas

Question 2

Presentation

Answer 2

Fluctuating cognitive impairment more dominant
Parkinsonism follows
-visual hallucinations (animals, children), delusions
-repeated falls
-incontinence, constipation
-REM sleep disorders

Question 3

Diagnosis

Answer 3

Clinical

Can use DaTscan - assess for Lewy bodies

Question 4

Investigations to rule out the reversible causes

Answer 4

Drugs - medication review (BZ, opioids, anticholinergics, antipsychotics, antidepressants, alcohol)

Endocrine - hypothyroidism, Addisons

Mental - depression

Nutritional - B12 (ataxia, memory loss, gait abnormalities), thiamine deficiency (Wernicke’s enceph, Korsakoff psychosis)

Trauma - subdural haemorrhage

Tumour - brain malignancy

Infection - syphillis

Question 5

Management - medical

• what can you use
• what should you avoid

Answer 5

Same as AD

Avoid antipsychotics if possible - block D rec
-unless risk to others/self, symptoms causing distress