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Diffuse Lewy Body Disease:Clinical Features in 15 Cases
JNNP 52:709-717, Byrne,E.J., 1989
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Article Abstract
Fifteen cases of diffuse Lewy body disease were diagnosed on pathological grounds during a single year in one health district.The range and frequency of clinical features contrast strikingly with previous reports. The majority of cases presented with classical levodopa-responsive Parkinson's disease either alone(6 cases)or with mild cognitive impairment (3 cases);the remaining 6 cases presented with cognitive impairment alone. In time almost all patients developed both dementia and Parkinsonism.The dementia was cortical in type,but unusual in that most(12 cases)showed day-to-day fluctuation in severity at some point in their illness.These findings suggest that diffuse Lewy body disease is not rare,and that it presents in a range of ways from dementia with subsequent Parkinsonism to Parkinson's disease with subsequent dementia.The latter mode of presentation suggests that it should be considered as a significant pathological substrate of dementia in Parkinson's disease.
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burst suppression pattern,electroencephalogram
delusion
dementia
falling
hallucination
L-dopa
Lewy body disease,diffuse
neuropathology
Parkinson disease
Parkinson disease,L-dopa nonresponsive
Parkinsonism syndrome
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