Doctor's Notes on Dementia with Lewy Bodies
Lewy body dementia (LBD) is a syndrome that describes dementia associated with or possibly caused by small clumps of proteins that abnormally aggregate inside nerve cells in the brain. Signs and symptoms are early cognitive impairment like loss of recent memory and difficulty thinking and behavioral disturbances like depression, delusions, and hallucinations but not motor symptoms like tremors or foot shuffling as is the case for Parkinson's disease. However, motor symptoms can appear later as the disease progresses. Signs and symptoms slowly progress over time. Finding Lewy bodies in brain cells at autopsy is the only confirmation of Lewy bodies in brain cells.
The cause of Lewy body dementia and even the cause of Lewy body formation is unknown. Some researchers suggest Lewy bodies aggregate and eventually damage and kill the brain cell they inhabit, while others suggest Lewy body formation is a symptom of an unknown toxic event in the brain cell.
What Are the Treatments for Lewy Body Dementia?
The treatments available for Lewy body dementia may help to slow the onset of some symptoms or reduce symptoms, but there is no cure for this progressive disease. Treatments include the following:
- Cholinesterase inhibitors increase chemical messengers in the brain.
- Parkinson's disease medications reduce rigid muscles and slow movements.
- Carbidopa-levodopa
- Other medications to treat various symptoms
- Sleep medications
- Antipsychotics
- Movement (dyskinesias)
Non-drug therapies are designed to treat this disease by not using drugs:
- Tolerating abnormal behaviors
- Environment modification (simplify and declutter living areas)
- Making daily tasks and routines simple
The patient's medical team can help design the best treatment protocol for each patient.
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REFERENCE:
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.