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Definition

Dementia is the progressive loss of memory and various other mental functions, including the ability to learn, reason, and judge. Lewy body disease, which is one of the second most common type of progressive dementia, is caused by the build up of Lewy bodies (abnormal protein deposits) inside brain cells that control certain aspects of memory and motor control.

Brain Cells

Causes

It is not clear exactly what causes the build up of Lewy bodies in the brain, but Lewy body disease is linked to Parkinson's disease, multiple system atrophy, and other disorders.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition. The following factors may increase your risk of developing Lewy body disease:

Gender: male
Age: 53-83 years
Family history of Lewy body disease

Symptoms

Lewy body disease is characterized by:

Fluctuations in alertness and attention
- Frequent drowsiness
- Lethargy
- Staring into space
- Disorganized speech
- Insomnia
Recurrent visual hallucinations
Poor regulation of body temperature and blood pressure
Obsessive/compulsive behaviors
Forgetfulness
Parkinsonian motor symptoms
- Rigidity
- Loss of spontaneous movement

Diagnosis

The only way to diagnose Lewy body disease conclusively is through an autopsy. But a doctor can perform tests to narrow the cause of dementia. He or she will ask about symptoms and medical history, and perform a physical exam. Other tests may include:

Memory, language, and other tests
Patient and family interviews
CT scan—a type of x-ray that uses a computer to make pictures of structures inside the body
MRI scan—a test that uses magnetic waves to make pictures of structures inside the body
Blood tests

Treatment

While there is no cure for Lewy body disease, there are treatments that can control its symptoms. Talk with your doctor about the best treatment plan for you. Treatment options include:

Medications

Medications such as donepezil and rivastigmine can help with many of the symptoms of Lewy body disease. Levodopa can be used to help control rigidity and loss of spontaneous movement. In addition, some people benefit from antidepressants, anticonvulsants, and neuroleptics.

Other Treatments

Physical therapy, massage, exercise, music, and aromatherapy may benefit some people with this condition.

Prevention

There is no known direct prevention against Lewy body disease.

RESOURCES:

Lewy Body Dementia Association

http://www.lewybodydementia.org/

National Institute of Neurological Disorders and Stroke

http://www.ninds.nih.gov/

CANADIAN RESOURCES:

Alzheimer Society

http://www.alzheimer.ca/

Canadian Stroke Network

http://www.canadianstrokenetwork.ca/

References:

Ballard CG, Chalmers KA, Todd C, McKeith IG, O'Brien JT, Wilcock G, et al. Cholinesterase inhibitors reduce cortical Abeta in dementia with Lewy bodies. Neurology. 2007;68:1726-1729.

Bouchard RW. Diagnostic criteria of dementia [review]. Can J Neurol Sci. 2007;34:(Suppl 1)S11-18.

Camicioli R, Gauthier S. Clinical trials in Parkinson's disease dementia and dementia with Lewy bodies [review]. Can J Neurol Sci. 2007;34:(Suppl 1)S109-117.

Chaudry, A, Khan, F. Dementia with Lewy bodies. In: Gilman S, ed. MedLink Neurology. San Diego, CA: MedLink Corporation. Available at: http://www.medlink.com. Accessed August 10, 2007.

Chou KL, Borek LL, Friedman JH. The management of psychosis in movement disorder patients [review]. Expert Opin Pharmacother. 2007;8:935-943.

Dementia. Health Library website. Available at: http://healthlibrary.epnet.com.

Dementia with Lewy bodies information page. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/dementiawithlewybodies/dementiawithlewybodies.htm. Accessed June 25, 2007.

Kemp PM, Hoffmann SA, Tossici-Bolt L, Fleming JS, Holmes C. Limitations of the HMPAO SPECT appearances of occipital lobe perfusion in the differential diagnosis of dementia with Lewy bodies. Nucl Med Commun. 2007;28:451-456.

Lewy body disease: LBD. Lewy Body Disease Association website. Available at: http://www.lewybodydementia.org/docs/brochure/3_brochure.pdf. Accessed June 25, 2007.

Last reviewed August 2007 by J. Thomas Megerian, MD, PhD, FAAP

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

Lewy Body Disease

(Lewy Body Dementia, Dementia With Lewy Bodies)