DEMENTIA TYPE-LEWY BODY DEMENTIA

SUMMARY

1. Different pathophysiology from PD; dementia may affect 80% of PD patients.

2. Lewy bodies are spherical eosinophilic inclusions (alpha-synuclein) within neurons.

3. Can occur within cerebral cortex, lambic cortex, hippocampus, midbrain & basal ganglia, olfactory pathways.

FEATURES
3. Cerebral cortex: 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. Limbic cortex: emotions, behaviour, sleep regulation. Behavioral issues: depression, apathy, anxiety, agitation, delusions & paranoia.

5. Midbrain & basal ganglia: spontaneous motor features of Parkinsonism; recurrent, vivid visual hallucinations; and prominent fluctuations of attention and cognition.

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

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].