Contributions of other brain pathologies in dementia with lewy bodies.

• The clinical picture with its pathological correlate was analysed in 16 patients fulfilling consensus criteria for dementia with Lewy bodies (DLB). The cases were part of a larger cohort (n = 200) of patients within a prospective longitudinal study of dementing disorders. Six cases exhibited not only Lewy bodies (LBs) but also other brain pathologies such as Alzheimer changes, multiple infarcts or complete and incomplete white matter infarcts. Degeneration of the nucleus basalis of Meynert and substantia nigra was also seen. The 10 cases without LBs all had Alzheimer changes. In 7 cases, these changes were combined with mainly incomplete frontal white matter infarcts. However, the degeneration of brain stem nuclei was less pronounced in these cases. Symptoms such as fluctuations in cognition, falls and episodic confusion appeared in association with arterial hypotension, which developed during the course of dementia in almost all the 16 cases. The majority of the cases were treated with neuroleptics and other potentially hypotensive medication. This study shows that multiple and different pathological features may contribute to a clinical symptom constellation as in DLB. The case study approach reveals the complexity of the clinico-pathological relationships in dementia that might otherwise be lost in the analysis of larger group data. Copyright 2002 S. Karger AG, Basel

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Neurologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Neurology (hsv//eng)

Nyckelord

Hallucinations/pathology/radionuclide imaging

Male

Middle Age

Lewy Body Disease/drug therapy/*pathology/*radionuclide imaging

Aged

Human

Antipsychotic Agents/therapeutic use

Alzheimer Disease/drug therapy/pathology/radionuclide imaging

Basal Ganglia Diseases/pathology/radionuclide imaging

Female

Cerebrovascular Circulation

Cerebral Infarction/drug therapy/pathology/radionuclide imaging

Cardiovascular Diseases/pathology/radionuclide imaging

Blood

Publikations- och innehållstyp

art (ämneskategori)

ref (ämneskategori)