Lewy Body Disease and Dementia

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Lewy Body Disease and Dementia
Arch Int Med 156:487-493, Kalra,S.,et al, 1996 See this aricle in Pubmed

Article Abstract
Lewy bodies(LBs)are intracytoplasmic neuronal inclusions sometimes found in the brain stem,diencephalon,basal ganglia and cerebral cortex.Cases designated as diffuse Lewy body disease(DLBD)demonstrate widespread cortical and subcortical Lewy body formation.The fact that DLBD is possibly the second most common cause of dementia after Alzheimer's disease is not generally recognized.We hope to emphasize the importance of this common neurodegenerative disorder by reviewing the literature and our own experience with DLBD.The English language literature dealing with the clinical and pathologic features of DLBD was reviewed.Pathologic material from the Canadian Brain Tissue Bank,Toronto,Ontario,was reviewed over a two year period from 1991 to 1993.Prominent LB pathology may occur in isolation or mixed with pathological changes seen in Alzheimer's disease. Lewy body diseases include Parkinson's disease that presents with a classic movement disorder and sometimes dementia,and DLBD where LBs occur in a widespread distribution in the cortex in addition to the usual subcortical sites.Diffuse LB disease usually presents with a neurobehavioral syndrome that may include hallucinations,delusions and psychosis;all patients eventually become demented.A day-to-day fluctuating mental state maybe an important distinguishing clinical feature.Serious life-threatening side effects may occur with the use of standard neuroleptics.The variable clinical features and additional presence of Alzheimer-type pathological changes in many cases of DLBD has led to a confusing and inconsistent classification of LB disease and together with little awareness of its existence and its misdiagnosis.

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