DR Medhat MRCP

Lewy body dementia
- Is the second most common cause of dementia in the elderly after Alzheimer's
disease (20% of cases).
- The characteristic pathological feature is cytoplasmic neuronal inclusions (Lewy
bodies) which are proteins in the substantia nigra, paralimbic and neocortical areas.
- The relationship between Parkinson's disease and Lewy body dementia is
complicated, particularly as dementia is often seen in Parkinson's disease.
- Also, up to 40% of patients with Alzheimer's have Lewy bodies.
- Neuroleptics (antipsychotic drugs) should be avoided in Lewy body dementia as
patients are extremely sensitive and may develop irreversible Parkinsonism.
MRCP - Questions may give a history of a patient who has deteriorated following the
introduction -
of an antipsychotic agent
Features
1) Progressive cognitive impairment.
2) Intermittent confusion.
3) Parkinsonism.
4) Visual hallucinations.
5) Delusions and non-visual hallucinations.
6) Myoclonus
7) Marked sensitivity to neuroleptics.
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