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Lewy Body Dementia

Updated : April 17, 2024





Background

Lewy Body Dementia is a chronic neurological disease include dementia parkinsonian symptoms, and psychosis. After alzheimer’s disease and vascular dementia it is the third most common kind of dementia. Although the relationship between lewy body dementia and Parkinson’s disease is unknowna 12-month guideline distinguish the two conditions. In most cases of this condition particularly visual hallucinations and decreased responsiveness occurs before to motor symptoms. 

Epidemiology

Most people who suffered from Lewy Body Dementia suffer from both absence of awareness and clinical symptoms that are similar with symptoms of more common ailments like Parkinson and Alzheimer, this condition gets underdiagnosed. Nevertheless according to the latest research there is a possibility that it accounts for 20–30% of the total dementias. 
 
This condition affects more elderly individuals; it occurs frequently with men. It occurs in a large portion of the population of African American as well as the European population. The risk of a patient’s diagnosis increases if already in the family the Parkinson’s disease or Lewy body dementia is present. 

Anatomy

Pathophysiology

Ach insufficiency is a more severe sign of Lewy Body Dementia which is comparable to Alzheimer’s disease. Less acetylcholine in the parietal cortex and temporal lobe is the source of visual hallucinations a defining feature of Lewy Body Dementia; on the other hand the temporal lobe’s muscarinic M1 sensors are overexpressed in the case of delusions. Moreover, dopamine levels decrease.
Post-mortem tests reveal that Lewy Body Dementia affects the locus ceruleus dorsal raphe and dorsal motor nucleus of the vagus nerve and substantia nigra. 

Alpha-synuclein a presynaptic protein whose function is yet unknown is a key element in Lewy Body Dementia. Additionally neurofilament proteins and ubiquitin have been identified. Compared to Parkinson’s illness Lewy body dementia has a far more severe Ach decrease.  

Etiology

The main cause is unknown. However, more study is needed to determine whether environmental variables genetics and aging-related changes are involved. 

Genetics

Prognostic Factors

Lewy body dementia outlooks are generally fair to bad. The reason why patients pass away is most often due to various reasons such as pneumonia sinus problems movement restrictions or heart issues or medication side effects or depression or breaking bones that result in self-inflicted death. After the time of the first cancer diagnose a patient is given a life expectancy of only five years the maximum being eight years. 

Clinical History

Age Group 

The age group which is more affected by this condition is usually above 50 years. 

Physical Examination

Neurological Examination 

Cognitive Assessment 

Visual Examination 

Sleep Assessment 

Age group

Associated comorbidity

Leukemia and Parkinson’s disease both cause tremors stiff muscles and issues with balance and coordination.  
One characteristic of this condition is progressive cognitive decline which includes problems with memory attention and visuospatial abilities.  
People with this may hallucinate or delusions or depression or anxiety or agitation and trouble sleeping 
LBD-related autonomic dysfunction can cause symptoms such orthostatic hypotension incontinence constipation and difficulty regulating body temperature.  

Associated activity

Acuity of presentation

Often the signs and symptoms of this condition develop gradually over time. Together with moderate cognitive function impairments such memory attention and executive function problems this slow start may also involve behavioural and emotional disturbances.  
Individuals with LBD may have periods of clarity punctuated by sharp declines in cognitive and attentional capacities. These fluctuations might occur during the day or over a few weeks or months.  
Some patients with this condition may first have tremors muscular stiffness slowness of movement and problems with balance and coordination which are symptoms of Parkinson’s disease.  

Differential Diagnoses

Alzheimer’s Disease  

Parkinson’s Disease  

Frontotemporal Dementia 

Vascular Dementia  

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

Staging

Treatment Paradigm

Treatments like physical and occupational therapy can help individuals with learning disabilities maintain their functional abilities improve their mobility and reduce their chance of falling.  

Speech therapy is not only for helping people with communication problems and swallowing disorders as their sometimes present in this condition but also with assisting these people. 

Some behavioural symptoms that may be managed with the use of behavioural therapy include hallucinations anxiety and agitation. 

by Stage

by Modality

Chemotherapy

Radiation Therapy

Surgical Interventions

Hormone Therapy

Immunotherapy

Hyperthermia

Photodynamic Therapy

Stem Cell Transplant

Targeted Therapy

Palliative Care

Use of non-pharmacological approach for Lewy Body Dementia: Specialty

Minimize Clutter and Environment: To avoid confusion and irritation minimize clutter and get rid of extraneous things in the living area.  
Assure Accessibility and Safety: Eliminate any potential falls risks and impediments such as loose carpets electrical cords and furniture.  
To improve visibility and lower the chance of accidents especially at night make sure the area is well-lit.  
Establish comfortable atmosphere: To avoid sensory overload and encourage relaxation minimize noise and distractions in the surrounding area.  
Create a relaxing ambiance with comfortable furnishings gentle lighting and calming colours.  

Role of cholinesterase Inhibitors for Lewy Body Dementia

Acetylcholine is a neurotransmitter important in memory cognition and other brain processes. Donepezil acts by preventing its breakdown.  
Elevating acetylcholine levels in the brain can boost cholinergic neurotransmission, potentially ameliorating cognitive decline and symptoms including disorientation memory loss and concentration problems.  

Effectiveness of benzodiazepine for Lewy Body Dementia

Clonazepam: Clonazepam a long-acting benzodiazepine increases GABA inhibition and prevents muscular contraction. 

Use of Antipsychotics in treating Lewy Body Dementia

Clozapine: When clozapine is administered at the dosages necessary to treat schizophrenia symptoms that are not responsive to conventional neuroleptics there is a risk of agranulocytosis. 

Use of Intervention with a procedure in treating Lewy Body

Deep Brain Stimulation and Deep Brain Lesioning are two surgical treatment options exhibiting their effectiveness by inserting electrodes into certain brain regions to create heat/electrical currents and destroy the tissue afterwards. 

Use of phases in managing Lewy Body Dementia

Identification and Diagnosis: Sign and symptom observations provide successful accurate diagnosis.  

Taking over symptoms involves here the impaired cognitive function or motor and behavioural manifestations which is crucial in this disease.
Care Coordination and Planning: Progressive deterioration gradually makes patients and their families requests more help and relates resources. 

Medication

Media Gallary

Lewy Body Dementia

Updated : April 17, 2024




Lewy Body Dementia is a chronic neurological disease include dementia parkinsonian symptoms, and psychosis. After alzheimer’s disease and vascular dementia it is the third most common kind of dementia. Although the relationship between lewy body dementia and Parkinson’s disease is unknowna 12-month guideline distinguish the two conditions. In most cases of this condition particularly visual hallucinations and decreased responsiveness occurs before to motor symptoms. 

Most people who suffered from Lewy Body Dementia suffer from both absence of awareness and clinical symptoms that are similar with symptoms of more common ailments like Parkinson and Alzheimer, this condition gets underdiagnosed. Nevertheless according to the latest research there is a possibility that it accounts for 20–30% of the total dementias. 
 
This condition affects more elderly individuals; it occurs frequently with men. It occurs in a large portion of the population of African American as well as the European population. The risk of a patient’s diagnosis increases if already in the family the Parkinson’s disease or Lewy body dementia is present. 

Ach insufficiency is a more severe sign of Lewy Body Dementia which is comparable to Alzheimer’s disease. Less acetylcholine in the parietal cortex and temporal lobe is the source of visual hallucinations a defining feature of Lewy Body Dementia; on the other hand the temporal lobe’s muscarinic M1 sensors are overexpressed in the case of delusions. Moreover, dopamine levels decrease.
Post-mortem tests reveal that Lewy Body Dementia affects the locus ceruleus dorsal raphe and dorsal motor nucleus of the vagus nerve and substantia nigra. 

Alpha-synuclein a presynaptic protein whose function is yet unknown is a key element in Lewy Body Dementia. Additionally neurofilament proteins and ubiquitin have been identified. Compared to Parkinson’s illness Lewy body dementia has a far more severe Ach decrease.  

The main cause is unknown. However, more study is needed to determine whether environmental variables genetics and aging-related changes are involved. 

Lewy body dementia outlooks are generally fair to bad. The reason why patients pass away is most often due to various reasons such as pneumonia sinus problems movement restrictions or heart issues or medication side effects or depression or breaking bones that result in self-inflicted death. After the time of the first cancer diagnose a patient is given a life expectancy of only five years the maximum being eight years. 

Age Group 

The age group which is more affected by this condition is usually above 50 years. 

Neurological Examination 

Cognitive Assessment 

Visual Examination 

Sleep Assessment 

Leukemia and Parkinson’s disease both cause tremors stiff muscles and issues with balance and coordination.  
One characteristic of this condition is progressive cognitive decline which includes problems with memory attention and visuospatial abilities.  
People with this may hallucinate or delusions or depression or anxiety or agitation and trouble sleeping 
LBD-related autonomic dysfunction can cause symptoms such orthostatic hypotension incontinence constipation and difficulty regulating body temperature.  

Often the signs and symptoms of this condition develop gradually over time. Together with moderate cognitive function impairments such memory attention and executive function problems this slow start may also involve behavioural and emotional disturbances.  
Individuals with LBD may have periods of clarity punctuated by sharp declines in cognitive and attentional capacities. These fluctuations might occur during the day or over a few weeks or months.  
Some patients with this condition may first have tremors muscular stiffness slowness of movement and problems with balance and coordination which are symptoms of Parkinson’s disease.  

Alzheimer’s Disease  

Parkinson’s Disease  

Frontotemporal Dementia 

Vascular Dementia  

Treatments like physical and occupational therapy can help individuals with learning disabilities maintain their functional abilities improve their mobility and reduce their chance of falling.  

Speech therapy is not only for helping people with communication problems and swallowing disorders as their sometimes present in this condition but also with assisting these people. 

Some behavioural symptoms that may be managed with the use of behavioural therapy include hallucinations anxiety and agitation. 

Minimize Clutter and Environment: To avoid confusion and irritation minimize clutter and get rid of extraneous things in the living area.  
Assure Accessibility and Safety: Eliminate any potential falls risks and impediments such as loose carpets electrical cords and furniture.  
To improve visibility and lower the chance of accidents especially at night make sure the area is well-lit.  
Establish comfortable atmosphere: To avoid sensory overload and encourage relaxation minimize noise and distractions in the surrounding area.  
Create a relaxing ambiance with comfortable furnishings gentle lighting and calming colours.  

Acetylcholine is a neurotransmitter important in memory cognition and other brain processes. Donepezil acts by preventing its breakdown.  
Elevating acetylcholine levels in the brain can boost cholinergic neurotransmission, potentially ameliorating cognitive decline and symptoms including disorientation memory loss and concentration problems.  

Clonazepam: Clonazepam a long-acting benzodiazepine increases GABA inhibition and prevents muscular contraction. 

Clozapine: When clozapine is administered at the dosages necessary to treat schizophrenia symptoms that are not responsive to conventional neuroleptics there is a risk of agranulocytosis. 

Deep Brain Stimulation and Deep Brain Lesioning are two surgical treatment options exhibiting their effectiveness by inserting electrodes into certain brain regions to create heat/electrical currents and destroy the tissue afterwards. 

Identification and Diagnosis: Sign and symptom observations provide successful accurate diagnosis.  

Taking over symptoms involves here the impaired cognitive function or motor and behavioural manifestations which is crucial in this disease.
Care Coordination and Planning: Progressive deterioration gradually makes patients and their families requests more help and relates resources.