Lewy body dementia

The illness Lewy Body Dementia (LBD) is one of the kinds of dementia.  It may consist of symptoms of Parkinsons disease and dementia.  Other helpful characteristics are visual hallucination symptoms, especially of white, brown or grey people or animals.  Another symptom may be REM sleep behavior disorder, which results in purposeful activity during dreaming (sleep walking or talking for example).

The first important step in evaluating a person in this condition is to promote personal and family safety and to determine if a medical illness or an adverse reaction to medication is present.  Keeping the patient under observation with minimal stimulation may help to keep them calm and unreactive, although this is not always easy to accomplish.

Blood and urine tests are often done to evaluate for causes of these symptoms.  In LBD, these are normal.  A secondary evaluation may include a CT scan or MRI study of the head.

The key clinical features of Lewy body dementia are variable cognitive difficulty, especially with respect to complex thinking tasks, symptoms of Parkinsons disease, and complex hallucinations, often of a visual origin.  Patients with Lewy body dementia also show Lewy body formations in the brain.  These must be detected by autopsy.  Patients with LBD tend to be sensitive to medications like haloperidol, and these should not be used if possible.

Treatment of Lewy Body Dementia

When behavioral concerns are present, and safety is an issue, sedating medication may be helpful.  Medications useful to treat Alzheimer disease may not be effective in LBD.

There is no cure for Lewy body dementia.  Supportive care, safety and quality of life are important.  Setting up a durable power of attorney and living will is important.