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DEMENTIA TYPE-PARKINSON & LEWY BODY DEMENTIA

Neurology

DEMENTIA TYPE-PARKINSON & LEWY BODY DEMENTIA

1. Parkinson disease (PD) is caused by a loss of dopaminergic neurons in the substantia nigra, may affect 80% of patients.

2. Lewy bodies are spherical eosinophilic inclusions within neurons.

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3. In contrast to Alzheimer disease, primarily affects executive functions and attention in its earlier stages, with relative sparing of language, memory, and calculations until later in the disease course.

4. The core clinical features (besides dementia) are spontaneous motor features of parkinsonism; recurrent, vivid visual hallucinations; and prominent fluctuations of attention and cognition.

5. When dementia precedes or develops within 1 year after the onset of motor dysfunction, it is referred to as Lewy Body Dementia (LBD).

6. Both the dementia and psychosis may be at least partially responsive to acetylcholinesterase inhibitors & memantine.

7. Poor response to the older antipsychotic drugs that block the D 2 dopamine receptor (other than clozapine & quetiapine, which spare D 2 ) including haloperidol and chlorpromazine - severe worsening of symptoms with extreme sedation, increased confusion, and postural instability with falls.


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REFERENCES

1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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