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Lewy body dementia is a type of dementia characterized by protein lumps in neurons, causing cognitive and motor symptoms similar to Parkinson’s. Diagnosis can be tricky, and there is no cure, but medication and care can manage symptoms. Patients are hypersensitive to antipsychotic drugs.
Lewy body dementia is a type of dementia, or adult-acquired cognitive impairment, characterized by the presence of lumps of protein in neurons or nerve cells, called Lewy bodies. This physical feature of the disease is named after the neurologist Frederic Lewy, who identified them in the early 20th century. Lewy bodies can only be detected in a postmortem brain biopsy, although Lewy body dementia can be diagnosed based on its symptoms. This type of dementia is theorized to be the second most common form in the elderly, after Alzheimer’s syndrome. The cause of the disease is unknown, but it is thought to have a genetic component.
In addition to loss of cognitive function, dementia with Lewy bodies causes motor symptoms similar to those of Parkinson disease. Because Parkinson’s disease can also cause dementia, accurate diagnosis can be tricky. Lewy body dementia is typically diagnosed when the onset of dementia is rapid and coincides with the onset of motor symptoms. Parkinson disease-related dementia most commonly occurs at least one year after the onset of motor symptoms.
There are three main symptoms of Lewy body dementia. The first is variable cognition, with patient alertness and mental clarity coming and going. The second symptom is visual hallucinations, often of animals or people. The third is motor dysfunction, similar to that seen in Parkinson’s. Motor symptoms can take the form of stiff, shuffling movements, decreased facial expressions and speech volume, drooling, and swallowing problems.
There is no cure for dementia with Lewy bodies, but it can be managed with medication and care. Pharmaceutical treatment must strike a balance between the drugs used, as drugs used to treat motor function problems can cause cognitive problems to worsen and vice versa. Donepezil is often used to treat the cognitive symptoms of the disease, while a combination of carbidopa and levodopa can address motor function impairment. Patients with Lewy body dementia are hypersensitive to antipsychotic drugs, such as haloperidol and thioridazine, which can induce coma and threaten the patient’s life.
Care is important because patients eventually become unable to care for themselves. It is important to monitor the patient for any signs of injury and illness, as they may have difficulty communicating these. In addition to taking care of the patient’s basic daily needs, treatment may include simplifying the patient’s environment and activities and encouraging regular exercise.
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