Dementia with Lewy bodies
From IDWiki
Pathophysiology
- Alpha-synuclein inclusions (Lewy bodies)
Diagnosis
- Fluctuation in cognition over days or weeks
- Recurrent visual hallucinations that are typically well-formed and non-threatening
- Parkinsonism
- REM sleep behaviour disorder, which can precede the diagnosis by years
- Occurs hours after sleeping
- May notice tangled sheets on waking
- Numerous supporting features
- Biomarkers on SPECT/PET, myocardial scintigraphy, polysomnography
Management
- Cholinesterase inhibitors (especially rivastigmine)
- Do NOT use first-generation antipsychotics
- Can try quetiapine or olanzapine
