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Lewy Body Dementia

A neurodegenerative dementia defined by alpha-synuclein pathology, cognitive fluctuation, visual hallucinations, and parkinsonism.

Written by: Saygı Hospital Health Guide Editorial Board
Published:

This content is for general information; please consult your physician for diagnosis and treatment.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Nöroloji department. Book Appointment →

What is Lewy Body Dementia?

Dementia with Lewy bodies (DLB) and Parkinson disease dementia (PDD) are clinically overlapping disorders united by alpha-synuclein pathology in the form of Lewy bodies and neurites throughout the brainstem, limbic system, and cortex. Together they are the second most common degenerative dementia.

The 2017 consensus criteria define probable DLB by two or more core features: fluctuating cognition with pronounced variations in attention, recurrent visual hallucinations, REM sleep behavior disorder, and parkinsonism. Supporting biomarkers include reduced dopamine transporter uptake on DaTscan and low uptake on MIBG cardiac scintigraphy.

Cognitive impairment preferentially affects attention, executive function, and visuospatial skills, with relative sparing of memory early in the disease. Autonomic dysfunction, constipation, and severe sensitivity to neuroleptics are characteristic.

Multidisciplinary care is essential to balance motor, cognitive, and psychiatric needs without provoking dangerous drug reactions.

Symptoms

Fluctuating cognition, attention, and alertness
Recurrent well-formed visual hallucinations, often of people or animals
Parkinsonism with bradykinesia, rigidity, and occasional tremor
REM sleep behavior disorder with dream enactment
Severe sensitivity to antipsychotic medications
Orthostatic hypotension, constipation, and other autonomic symptoms

Risk Factors

Advancing age with male predominance
Family history of DLB or Parkinson disease
GBA mutations and other genetic variants
Prior REM sleep behavior disorder as a prodromal marker
Anosmia and depression years before diagnosis
Cardiovascular risk factors contributing to mixed pathology

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Visual hallucinations or severe cognitive fluctuation with or without parkinsonism
  • Severe sensitivity or worsening after antipsychotic prescription
  • Dream-enactment behavior causing injury to patient or bed partner

Treatment Methods

01
Cholinesterase inhibitors, especially rivastigmine, for cognitive and behavioral symptoms
02
Low-dose levodopa titrated cautiously for parkinsonism while monitoring hallucinations
03
Avoidance of typical antipsychotics; use quetiapine or pimavanserin if psychosis requires treatment
04
Melatonin and bedroom safety measures for REM sleep behavior disorder
05
Management of orthostatic hypotension with non-pharmacologic measures and midodrine or droxidopa
06
Caregiver education, advance care planning, and referral to cognitive-behavioral neurology services

Which Department to Visit?

You can visit our Nöroloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.