Psychiatria pre prax 1/2014

Dementia with Lewy bodies

Dementia with Lewy bodies, also known as diffuse Lewy body disease (DLBD), is a dementia of neurodegenerative origin. It is second only to Alzheimer’s disease as the most common neurodegenerative dementia and the third most common of all dementias. It has a specific pathology, with the occurrence of degeneration of the neuronal protein alpha-synuclein – similarly to Parkinson’s disease; however, cortical neurons are also affected to a varying degree. In addition, Alzheimer’s changes, neuronal tau protein degeneration, and amyloid plaque formation often occur in varying degrees. Clinically, there are several forms that overlap with each other – subcortical form, corticosubcortical form. DLBD is particularly characterized by the following features: Marked fluctuation of the condition occurs within a short time interval. Attention is the cognitive function to be first and most conspicuously affected. Associated deliria are frequent. There are visual or complex hallucinations accompanied by the formation of paranoid delusions. The occurrence of parkinsonian symptoms, particularly rigidity, often with falls, is frequent. The patients are oversensitive to antipsychotic drugs the administration of which increases the frequency of falls.

Keywords: dementia, hallucinations, Lewy bodies, falls, attention.