Lewy body disease
| Dementia with Lewy bodies | |
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| Synonyms | Lewy body dementia (LBD), diffuse Lewy body disease, cortical Lewy body disease, senile dementia of Lewy type |
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| A microscopic image of Lewy bodies | |
| Specialty | Neurology |
| Symptoms | Dementia, fluctuations in alertness, visual hallucinations, slowness of movement |
| Usual onset | After the age of 50 |
| Duration | Long term |
| Causes | Unknown |
| Diagnostic method | Based on symptoms after ruling out other conditions |
| Similar conditions | Parkinson's disease, Alzheimer's disease |
| Medication | Acetylcholinesterase inhibitors such as donepezil, levodopa |
| Frequency | 0.1% (>65 years old) |
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| External resources |
Dementia with Lewy bodies (DLB) is a type of dementia that worsens over time. Additional symptoms may include fluctuations in alertness, visual hallucinations, slowness of movement, trouble walking, and rigidity.Excessive movement during sleep and mood changes such as depression are also common.
The cause is unknown. Typically, no family history of the disease exists among those affected. The underlying mechanism involves the buildup of Lewy bodies, clumps of alpha-synuclein protein in neurons. It is classified as a neurodegenerative disorder. A diagnosis may be suspected based on symptoms, with blood tests and medical imaging done to rule out other possible causes. The differential diagnosis includes Parkinson's and Alzheimer's.
At present there is no cure. Treatments are supportive and attempt to relieve some of the motor and psychological symptoms associated with the disease.Acetylcholinesterase inhibitors, such as donepezil, may provide some benefit. Some motor problems may improve with levodopa.Antipsychotics, even for hallucinations, should generally be avoided due to side effects.
DLB is the most common cause of dementia after Alzheimer's disease and vascular dementia. It typically begins after the age of 50. About 0.1% of those over 65 are affected. Males appear to be more commonly affected than females. In the late part of the disease, people may depend entirely on others for their care. Life expectancy following diagnosis is about eight years. The abnormal deposits that cause the disease were discovered in 1912 by Frederic Lewy.
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