Lewy body dementia

Question 1

what is the definition of DLB?

Answer 1

A neurodegenerative disorder with parkinsonism, progressive cognitive decline, prominent executive dysfunction, and visuospatial impairment.
Essential for a diagnosis of dementia with Lewy bodies (DLB) is dementia, defined as a progressive cognitive decline of sufficient magnitude to interfere with normal social or occupational functions, or with usual daily activities.

Question 2

what are the risk factors for DLB?

Answer 2

Old age
Male
Family history

Question 3

what is the pathophysiology of DLB?

Answer 3

DLB is a degenerative disease of the CNS characterised by an accumulation of Lewy bodies in vulnerable sites. Lewy bodies were first described in idiopathic Parkinson’s disease. The pathology of DLB mimics that of idiopathic Parkinson’s disease. Lewy body inclusions are composed of the protein alpha-synuclein, a cytoplasmic protein associated with synaptic vesicles.

Question 4

what are the key presentations of DLB?

Answer 4

DLB is characterised by the following core clinical features (the first 3 typically occur early, and may persist throughout the course): fluctuating cognition; recurrent visual hallucinations; REM sleep behaviour disorder; and one or more spontaneous cardinal symptoms of parkinsonism: bradykinesia, rest tremor, or rigidity.

Question 5

how is DLB managed?

Answer 5

Benzodiazepines - behavioural disturbance and agitation