Lewy Body Definition, Symptoms and a Video to Help

Thanks to the Lewy Body Dementia Association (http://lbda.org/), there is a plethura of information available.  This includes webinars, videos, booklets, forums, support groups (still forming and growing in most parts), and information on the disease, along with medications and their uses.  It is a truly viable and reliable source of information for anyone who wishes to discover more about the disease.  

The following information is from their website, so I cannot take any credit, but to parlay it to you, the reader.

What is Lewy Body Dementia?

It is a progressive brain disease and the second most common cause of neurodegenerative dementia after Alzheimer’s disease.  Lewy body dementia is a “spectrum disorder”, meaning it can occur alone or in combination with Parkinson’s disease, or co-exist with Alzheimer’s disease.

Lewy Body Dementia is NOT a Rare Disease!

It accounts for up to 20% of dementia cases in the US - that’s up to 1.3 million cases in the US alone, with only 30-50% of LBD cases being accurately diagnosed, even in dementia centers.

Here is a link to a pdf on the Comprehensive Lewy Body Dementia Symptom Checklist, to be used for your information, and that of your medical team:  LBD Symptom Checklist

Early and Accurate Diagnosis is Important

Antipsychotic drugs may cause extreme adverse reactions in those with LBD.  Cholinesterase inhibitors may improve alertness and cognition and potentially reduce hallucinations and behavioral symptoms.

Lewy Body Dementias (LBD) Include:

Parkinson’s Disease Dementia                           Dementia with Lewy Bodies (DLB)

(Items in bold are included in LBD diagnostic criteria:

Dementia Symptoms Specific to Lewy Body Dementia:

• Fluctuating Cognition
• Neuroleptic Sensitivity

LBD Symptoms that resemble Alzheimer’s

• Progressive Memory Loss
• Changes in Mood or Behavior
• Decreased Judgement and Insight
• Loss of Initiative
• Disorientation Regarding Time and Place
• Difficulty with Language and Tasks

Dementia Symptoms that Resemble Parkinson’s:

• Extrapyramidal Signs*
• Muscle Stiffness and rigidity
• Very Slow Movements, Frozen Stance
• Balancing Difficulties, Shuffling Gait
• Tremors
• Stooped Posture
• Blank Facial Expression
• Difficulty Swallowing, Weak Voice
• Restless Leg Syndrome
• Repeated Falls, Fainting, Myoclonus*

Additional Symptoms Typical of Lewy Body Dementia:

• Visual Hallucinations (also smell, sound, taste, touch)
• Transient/Unexplained Unresponsiveness
• Delusions, Mood Disorders
• Illusions
• Visuospatial Impairment (depth perception, object orientation)
• Sleep Disturbances, such as acting out vivid nightmares and dreams
• Autonomic Dysfunction (blood pressure fluctuations, constipation, incontinence, sexual dysfunction)

Clinical Management is Challenging Because

Antipsychotic drugs may cause worsening of confusion, Parkinsonism, heavy sedation, neuroleptic malignant syndrome.

Benzodiazepines, anticholinergics, and some surgical anesthetics, antidepressants, and over-the-counter medications may cause sedation, motor impairment or confusion.

Some medications for Parkinsonian symptoms may increase confusion, delusions, and hallucinations.

Please also view the video presented below:

*Neuroleptic Sensitivity:  The patient may experience a state of apathy, lack of initiative, and a limited range of emotion while taking the drugs to ease confusion, agitation, and to help with normalizing psychomotor coordination (Medicine.net)

*Extrapyramidal Signs: Physical symptoms include tremors, slurred speech, akathisia (state of agitation, distress, and restlessness that is an occasional side-effect of antipsychotic and antidepressant drugs), dystonia, anxiety, distress, paranoia, or bradyphrenia (a slow thought process brought upon by antipsychotic drugs), that are brought on by improper dosing or unusual reactions to antipsychotic drugs.

*Myoclonus:  Spasmodic jerky contraction of groups of muscles.