Dementia with Lewy bodies
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Clinic
- DLB is a type of dementia characterized by changes in sleep, behavior, cognition, movement, and regulation of automatic bodily functions.
- Together with Parkinson's disease dementia, DLB is one of the two Lewy body dementia.
Sign / Symptoms
- Memory loss is not always an early symptom
- REM sleep behavior disorder (RBD) is a core feature. It appears years or decades before other symptoms.
Other core features are
- Visual hallucinations
- Marked fluctuations in attention or alertness
- Parkinsonism (Slowness of movement, Trouble walking or Rigidity)
- Psychiatric symptoms, such as altered behavior, depression or apathy.
- Autonomic Dysfunction including [1]
Note:
- Visual hallucinations in DLB are generally vivid hallucinations of people or animals and often occur in falling asleep or waking up. So it's better to consider "Delirium" as an appropriate Miasmatic rubric.
- Abnormal sleep behaviors begin before cognitive decline and is a core feature of DLB.
- Memory loss is not always an early symptom
DBL Black Box
| FFI | |
|---|---|
| RBD | +++ |
| Delirium | +++ |
| Parkinsonism | +++ |
| Behavior change | +++ |
| Dementia | +++ |
| Constipation | +++ |
| Dysphagia | +++ |
- ↑ Allan LM. Diagnosis and Management of Autonomic Dysfunction in Dementia Syndromes. Curr Treat Options Neurol. 2019 Jul 10;21(8):38. doi: 10.1007/s11940-019-0581-2. PMID: 31290049; PMCID: PMC6617263.
- ↑ Londos, E., Hanxsson, O., Alm Hirsch, I. et al. Dysphagia in Lewy body dementia - a clinical observational study of swallowing function by videofluoroscopic examination. BMC Neurol 13, 140 (2013). https://doi.org/10.1186/1471-2377-13-140
- ↑ Ransmayr GN, Holliger S, Schletterer K, Heidler H, Deibl M, Poewe W, Madersbacher H, Kiss G. Lower urinary tract symptoms in dementia with Lewy bodies, Parkinson disease, and Alzheimer disease. Neurology. 2008 Jan 22;70(4):299-303. doi: 10.1212/01.wnl.0000296826.61499.26. PMID: 18209204.