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Semin Neurol 2014; 34(02): 182-188
DOI: 10.1055/s-0034-1381741
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Dementia with Lewy Bodies

Authors

  • Mary Catherine Mayo

    1   Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, California

  • Yvette Bordelon

    2   Movement Disorders Program, Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, California
Further Information

Publication History

Publication Date:
25 June 2014 (online)

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Abstract

Dementia with Lewy bodies (DLB) is the second most common diagnosis of dementia after Alzheimer disease (AD). The essential pathologic feature is the Lewy body, a neuronal inclusion containing α-synuclein, found in brainstem nuclei and the neocortex. Clinical features include early fluctuations in attention, hallucinations, and parkinsonism, with progression to a combined cortical and subcortical dementia. To distinguish it from Parkinson disease dementia, a time course of one year from cognitive changes to motor feature onset has been established. There is more severe impairment of verbal fluency, executive function, and visuospatial abilities in DLB patients. Both rapid eye movement sleep behavior disorder and neuroleptic sensitivity are notable in this patient group. Treatment is aimed at symptom management. Cholinesterase inhibitors can be beneficial for behavioral and cognitive issues, whereas dopaminergic agents may help motor symptoms. Survival is equivalent to AD when measured from symptom onset, though diagnosis in DLB may be delayed.

Keywords

dementia with Lewy bodies - Lewy body - synucleinopathy - dementia - parkinsonism