Lewy body dementia Flashcards
What is the characteristic pathological feature of Lewy Body Dementia?
Alpha-synuclein cytoplasmic inclusions (Lewy bodies) in the substantia nigra, paralimbic, and neocortical areas.
How does the progression of cognitive impairment in Lewy Body Dementia compare to Parkinson’s Disease?
In Lewy Body Dementia, cognitive impairment typically occurs before parkinsonism, whereas in Parkinson’s disease, motor symptoms generally appear at least one year before cognitive symptoms.
What cognitive impairments are commonly seen in the early stages of Lewy Body Dementia?
Early impairments include attention and executive function, rather than just memory loss, which is seen in Alzheimer’s disease.
What type of hallucinations are common in Lewy Body Dementia?
Visual hallucinations are common, but other features such as delusions and non-visual hallucinations may also be seen.
What imaging technique is commonly used to aid in diagnosing Lewy Body Dementia?
Single-photon emission computed tomography (SPECT), commercially known as DaTscan, is used. It has a sensitivity of around 90% and a specificity of 100%
Which medications are commonly used to manage Lewy Body Dementia?
Acetylcholinesterase inhibitors (e.g., donepezil, rivastigmine) and memantine are used, similar to the treatment for Alzheimer’s disease.
What should be avoided in the management of Lewy Body Dementia?
Neuroleptics should be avoided, as patients are extremely sensitive to them and may develop irreversible parkinsonism
What is the role of the DaTscan in diagnosing Lewy Body Dementia?
DaTscan uses a dopaminergic iodine-123-radiolabelled compound to assess the dopaminergic system, helping with the diagnosis. It has high sensitivity and specificity for Lewy Body Dementia.
How does Lewy Body Dementia typically differ from Alzheimer’s disease in terms of cognitive symptoms?
In Lewy Body Dementia, attention and executive function are affected early, while in Alzheimer’s disease, the primary early symptom is memory loss.
What is the relationship between Parkinson’s disease and Lewy Body Dementia?
The relationship is complicated as dementia can occur in Parkinson’s disease. Additionally, up to 40% of patients with Alzheimer’s disease have Lewy bodies.
