Dementia with Lewy bodies: Difference between revisions
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==Background== | ==Background== | ||
*Neurodegenerative disorder (dementia) | *Neurodegenerative disorder (dementia) | ||
*More rapid progression than Alzheimer's or Parkinson's | *More rapid progression than Alzheimer's or [[Parkinson's disease]] | ||
==Clinical Features== | ==Clinical Features== | ||
* | *Fluctuating cognition | ||
* | *Recurrent visual [[hallucinations]] | ||
*Parkinsonian motor symptoms (cogwheel rigidity, shuffling gait, retropulsion) | *Parkinsonian motor symptoms (cogwheel rigidity, shuffling gait, retropulsion) | ||
*REM-sleep disturbance | *REM-sleep disturbance | ||
*Neuroleptic sensitivity, increased risk for [[neuroleptic malignant syndrome]] | *Neuroleptic sensitivity, increased risk for [[neuroleptic malignant syndrome]] | ||
**Acute worsening of cognition or delirium, with antipsychotics, benzodiazepines, anticholinergics, surgical anesthetics | **Acute worsening of cognition or delirium, with [[antipsychotics]], [[benzodiazepines]], [[anticholinergics]], surgical anesthetics | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
===Dementia Acronym=== | |||
D = drug-induced | |||
E = emotions (depression especially) | |||
M = metabolic and endocrine issues | |||
E = eyes and ears (sensory problems) | |||
N = nutritional issues (B12 and Vit. D) | |||
T = tumors | |||
I = infections | |||
A = alcohol | |||
S = sleep disorders and rarely seizures | |||
{{Dementia DDX}} | |||
==Evaluation== | ==Evaluation== | ||
*See [[Dementia Work-Up]] | |||
==Management== | ==Management== | ||
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==See Also== | ==See Also== | ||
*[[Altered Mental Status]] | |||
*[[Dementia]] | |||
*[[Dementia Work-Up]] | |||
==External Links== | ==External Links== | ||
Latest revision as of 17:56, 27 March 2017
Background
- Neurodegenerative disorder (dementia)
- More rapid progression than Alzheimer's or Parkinson's disease
Clinical Features
- Fluctuating cognition
- Recurrent visual hallucinations
- Parkinsonian motor symptoms (cogwheel rigidity, shuffling gait, retropulsion)
- REM-sleep disturbance
- Neuroleptic sensitivity, increased risk for neuroleptic malignant syndrome
- Acute worsening of cognition or delirium, with antipsychotics, benzodiazepines, anticholinergics, surgical anesthetics
Differential Diagnosis
Dementia Acronym
D = drug-induced
E = emotions (depression especially)
M = metabolic and endocrine issues
E = eyes and ears (sensory problems)
N = nutritional issues (B12 and Vit. D)
T = tumors
I = infections
A = alcohol
S = sleep disorders and rarely seizures
Dementia
- Degenerative
- Alzheimer's disease
- Huntington's disease
- Parkinson's disease
- Vascular
- Multiple infarcts
- Hypoperfusion (MI, profound hypotension)
- Subdural hematoma
- SAH
- Infectious
- Meningitis (sequelae of bacterial, fungal, or tubercular)
- Neurosyphilis
- Viral encephalitis (HSV, HIV), Creutzfeldt-Jakob disease
- Inflammatory
- SLE
- Demyelinating disease (e.g. multiple sclerosis)
- Neoplastic
- Primary brain tumor / metastatic disease
- Carcinomatous meningitis
- Paraneoplastic syndromes
- Traumatic
- Toxic
- ETOH
- Meds (anticholinergics, polypharmacy)
- Metabolic
- Psychiatric
- Depression (pseudodementia)
- Hydrocephalic
- Normal pressure hydrocephalus (communicating hydrocephalus)
- Noncommunicating hydrocephalus
Evaluation
- See Dementia Work-Up
Management
- Avoid neuroleptics and anticholinergics
- Supportive care, symptom management