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1.
Dement. neuropsychol ; 14(1): 83-87, Jan.-Mar. 2020. graf
Artigo em Inglês | LILACS (Américas) | ID: biblio-1089818

RESUMO

ABSTRACT Ekbom Syndrome, also known as parasitosis delusion or psychogenic parasitosis, is a rare condition in which patients present with a fixed belief of being infested by parasites, vermin or small insects, along with tactile hallucinations (such as pruritus or sensations of the parasites crawling over or under the skin). The syndrome may occur idiopathically or be associated with other medical conditions and drug use. This case report describes the occurrence of Ekbom syndrome in a patient diagnosed with Lewy Body Dementia (LBD), a neurodegenerative disease that commonly presents with sensory perception and thought disorders and other neuropsychiatric symptoms. Although visual hallucination is considered a core diagnostic criterion, other modalities of psychiatric symptoms can also occur posing a further challenge for correct diagnosis. Proper recognition allows early diagnosis and adequate treatment, preventing hazardous antipsychotic use in these patients.


RESUMO A síndrome de Ekbom, também conhecida como delírio parasitário ou parasitose psicogênica, é uma condição rara na qual os pacientes apresentam crença fixa de estarem infestados por parasitas, vermes ou insetos, acompanhada de alucinações táteis (como prurido ou sensação dos parasitas andando sobre ou sob a pele). A síndrome pode ocorrer de forma idiopática ou associada a outras condições médicas ou uso de drogas. Este relato de caso descreve a ocorrência da síndrome de Ekbom em um paciente diagnosticado com Demência com corpos de Lewy (DCL), uma doença degenerativa que comumente se apresenta com desordens de sensopercepção e pensamento, e outros sintomas neuropsiquiátricos. A alucinação visual é considerada um dos critérios diagnósticos nucleares, entretanto outras modalidades de sintomas psiquiátricos podem ocorrer criando desafios adicionais ao diagnóstico correto. O reconhecimento apropriado permite o diagnóstico precoce e tratamento adequado, prevenindo o uso arriscado de antipsicóticos nesses pacientes.


Assuntos
Humanos , Síndrome das Pernas Inquietas , Automutilação , Doença por Corpos de Lewy , Delírio , Demência , Delírio de Parasitose
2.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-775166

RESUMO

BACKGROUND@#The facial expression of medical staff has been known to greatly affect the psychological state of patients, making them feel uneasy or conversely, cheering them up. By clarifying the characteristics of facial expression recognition ability in patients with Lewy body disease, the aim of this study is to examine points to facilitate smooth communication between caregivers and patients with the disease whose cognitive function has deteriorated.@*METHODS@#During the period from March 2016 to July 2017, we examined the characteristics of recognition of the six facial expressions of "happiness," "sadness," "fear," "anger," "surprise," and "disgust" for 107 people aged 60 years or more, both outpatient and inpatient, who hospital specialists had diagnosed with Lewy body diseases of Parkinson's disease, Parkinson's disease with dementia, and dementia with Lewy bodies. Based on facial expression recognition test results, we classified them by cluster analysis and clarified features of each type.@*RESULTS@#In patients with Lewy body disease, happiness was kept unaffected by aging, age of onset, duration of the disease, cognitive function, and apathy; however, recognizing the facial expression of fear was difficult. In addition, due to aging, cognitive decline, and apathy, the facial expression recognition ability for sadness and anger decreased. In particular, cognitive decline reduced recognition of all of the facial expressions except for happiness. The test accuracy rates were classified into three types using the cluster analysis: "stable type," "mixed type," and "reduced type". In the "reduced type", the overall facial recognition ability declined except happiness, and in the mixed type, recognition ability of anger particularly declined.@*CONCLUSION@#There were several facial expressions that the Lewy body disease patients were unable to accurately identify. Caregivers are recommended to make an effort to compensate for such situations with language or body contact, etc., as a way to convey correct feeling to the patients of each type.


Assuntos
Idoso , Idoso de 80 Anos ou mais , Análise por Conglomerados , Cognição , Fisiologia , Emoções , Expressão Facial , Reconhecimento Facial , Fisiologia , Feminino , Humanos , Doença por Corpos de Lewy , Psicologia , Masculino , Pessoa de Meia-Idade
3.
Rev. Hosp. Ital. B. Aires (2004) ; 37(3): 105-111, Sept. 2017. tab.
Artigo em Espanhol | LILACS (Américas) | ID: biblio-1087981

RESUMO

La enfermedad con cuerpos de Lewy incluye 2 entidades que podrían ser consideradas variantes clínicas de una misma patología: la demencia con cuerpos de Lewy y la demencia en enfermedad de Parkinson. Con la finalidad de describir correctamente lo que sucede en la evolución de la enfermedad se divide el cuadro en etapa prodrómica y de demencia propiamente dicha. La primera está clínicamente representada por aquel período en el cual, si bien el paciente exhibe algunos signos y síntomas propios de la enfermedad, no reúne criterios de demencia. A pesar de ser difícil de definir y por carecerse todavía de contundentes datos clínicos y biomarcadores, se caracteriza principalmente por deterioro leve selectivo en función atencional ­ visuoespacial, trastorno del sueño REM y disautonomía‒. La segunda etapa está claramente caracterizada en los criterios de consenso del año 2005. Recientemente hemos publicado la validación de un instrumento llamado ALBA Screening Instrument, que permite diagnosticar con alta sensibilidad y especificidad la enfermedad aun en etapas tempranas y diferenciarla de otras patologías semejantes. La tomografía por emisión de positrones (PET) para transportador de dopamina es el procedimiento de referencia (gold standard) del diagnóstico. El tratamiento sintomático con anticolinesterásicos y neurolépticos atípicos favorece una buena evolución de la enfermedad y es fundamental tener en cuenta evitar medicamentos que pueden dañar gravemente a los pacientes como los anticolinérgicos y antipsicóticos típicos. Los avances en el diagnóstico y la difusión del impacto de esta enfermedad en la población contribuirán a generar mayores esfuerzos de investigación para hallar un tratamiento eficaz, preventivo o curativo o de ambas características. (AU)


Lewy body disease includes 2 entities that could be considered clinical variants of the same pathology: Dementia with Lewy bodies and Parkinson's disease Dementia. Two stages of the disease are described in this review, a prodromal stage and one of explicit dementia. The first one is clinically represented by that period in which, the patient exhibits some typical features of the disease, but not dementia criteria. Despite being difficult to define the prodromal stage and that strong clinical data and biomarkers are still lacking, there is evidence to characterize it mainly by mild selective impairment in attention and visuo-spatial function, REM sleep disorder and dysautonomia. The second stage is clearly characterized in the known consensus criteria of 2005. We have recently published the validation of an instrument called ALBA Screening Instrument which showed a high sensitivity and specificity for diagnosis of the disease even in the early stages. It´s useful to differentiate the disease from other similar pathologies. Positron Emission Tomography for dopamine transporter is the gold standard of diagnosis in life. Symptomatic treatment with anticholinesterases and atypical neuroleptics help patients in their evolution of the disease. Anticholinergics and typical antipsychotics are agents to avoid in the treatmen of the disease because can severely damage patients. Future advances in the diagnosis and dissemination of the knowledge of the disease will contribute to generate greater research efforts to find an effective preventive and / or curative treatment. (AU)


Assuntos
Humanos , Doença por Corpos de Lewy/tratamento farmacológico , Doença por Corpos de Lewy/diagnóstico por imagem , Doença de Parkinson/patologia , Atenção , Sinais e Sintomas , Antipsicóticos/efeitos adversos , Antipsicóticos/uso terapêutico , Benzotropina/efeitos adversos , Biperideno/efeitos adversos , Carbidopa/administração & dosagem , Carbidopa/uso terapêutico , Levodopa/administração & dosagem , Levodopa/uso terapêutico , Triexifenidil/efeitos adversos , Inibidores da Colinesterase/uso terapêutico , Clozapina/administração & dosagem , Clozapina/uso terapêutico , Antagonistas Muscarínicos/efeitos adversos , Antagonistas de Dopamina/efeitos adversos , Agonistas de Dopamina/efeitos adversos , Antagonistas Colinérgicos/efeitos adversos , Risperidona/efeitos adversos , Doença por Corpos de Lewy/diagnóstico , Doença por Corpos de Lewy/etiologia , Doença por Corpos de Lewy/genética , Doença por Corpos de Lewy/patologia , Transtorno do Comportamento do Sono REM/complicações , Demência , Disautonomias Primárias/complicações , Sintomas Prodrômicos , Rivastigmina/administração & dosagem , Rivastigmina/uso terapêutico , Fumarato de Quetiapina/administração & dosagem , Fumarato de Quetiapina/uso terapêutico , Olanzapina/efeitos adversos , Donepezila/administração & dosagem , Donepezila/uso terapêutico , Haloperidol/efeitos adversos , Antagonistas dos Receptores Histamínicos/efeitos adversos , Hipnóticos e Sedativos/efeitos adversos , Antidepressivos Tricíclicos/efeitos adversos
4.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-152983

RESUMO

OBJECTIVE: Donepezil is used to improve cognitive impairment of dementia with Lewy bodies (DLB). Visuo-spatial dysfunction is a well-known symptom of DLB. Non-verbal Raven’s Colored Progressive Matrices (RCPM) were used to assess both visual perception and reasoning ability in DLB subjects treated with donepezil. METHODS: Twenty-one DLB patients (mean age, 78.7±4.5 years) were enrolled. RCPM assessment was performed at the time of starting donepezil and within one year after starting donepezil. RESULTS: There were significant improvements of RCPM in the total scores between one year donepezil treatment (p=0.013), in both Set A score (p=0.002) and Set AB score (p=0.015), but trend in the Set B score (p=0.083). CONCLUSION: Donepezil is useful for improving visuo-spatial impairment in DLB, but not for problem-solving impairment.


Assuntos
Inibidores da Colinesterase , Transtornos Cognitivos , Demência , Humanos , Corpos de Lewy , Doença por Corpos de Lewy , Processamento Espacial , Percepção Visual
5.
Chonnam Medical Journal ; : 145-150, 2016.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-788354

RESUMO

¹²³I-meta-iodobenzylguanidine (MIBG) has become widely applied in Japan since its introduction to clinical cardiology and neurology practice in the 1990s. Neurological studies found decreased cardiac uptake of ¹²³I-MIBG in Lewy-body diseases including Parkinson's disease and dementia with Lewy bodies. Thus, cardiac MIBG uptake is now considered a biomarker of Lewy body diseases. Although scintigraphic images of ¹²³I-MIBG can be visually interpreted, an average count ratio of heart-to-mediastinum (H/M) has commonly served as a semi-quantitative marker of sympathetic activity. Since H/M ratios significantly vary according to acquisition and processing conditions, quality control should be appropriate, and quantitation should be standardized. The threshold H/M ratio for differentiating Lewy-body disease is 2.0-2.1, and was based on standardized H/M ratios to comparable values of medium-energy collimators. Parkinson's disease can be separated from various types of parkinsonian syndromes using cardiac ¹²³I-MIBG, whereas activity is decreased on images of Lewy-body diseases using both ¹²³I-ioflupane for the striatum and ¹²³I-MIBG. Despite being a simple index, the H/M ratio of ¹²³I-MIBG uptake is reproducible and can serve as an effective tool to support a diagnosis of Lewy-body diseases in neurological practice.


Assuntos
3-Iodobenzilguanidina , Cardiologia , Demência , Diagnóstico , Japão , Corpos de Lewy , Doença por Corpos de Lewy , Neurologia , Medicina Nuclear , Doença de Parkinson , Transtornos Parkinsonianos , Controle de Qualidade
6.
Chonnam Medical Journal ; : 145-150, 2016.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-25334

RESUMO

¹²³I-meta-iodobenzylguanidine (MIBG) has become widely applied in Japan since its introduction to clinical cardiology and neurology practice in the 1990s. Neurological studies found decreased cardiac uptake of ¹²³I-MIBG in Lewy-body diseases including Parkinson's disease and dementia with Lewy bodies. Thus, cardiac MIBG uptake is now considered a biomarker of Lewy body diseases. Although scintigraphic images of ¹²³I-MIBG can be visually interpreted, an average count ratio of heart-to-mediastinum (H/M) has commonly served as a semi-quantitative marker of sympathetic activity. Since H/M ratios significantly vary according to acquisition and processing conditions, quality control should be appropriate, and quantitation should be standardized. The threshold H/M ratio for differentiating Lewy-body disease is 2.0-2.1, and was based on standardized H/M ratios to comparable values of medium-energy collimators. Parkinson's disease can be separated from various types of parkinsonian syndromes using cardiac ¹²³I-MIBG, whereas activity is decreased on images of Lewy-body diseases using both ¹²³I-ioflupane for the striatum and ¹²³I-MIBG. Despite being a simple index, the H/M ratio of ¹²³I-MIBG uptake is reproducible and can serve as an effective tool to support a diagnosis of Lewy-body diseases in neurological practice.


Assuntos
3-Iodobenzilguanidina , Cardiologia , Demência , Diagnóstico , Japão , Corpos de Lewy , Doença por Corpos de Lewy , Neurologia , Medicina Nuclear , Doença de Parkinson , Transtornos Parkinsonianos , Controle de Qualidade
8.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-202408

RESUMO

There are a variety of different causes of parkinsonism including PD, secondary parkinsonism, and the parkinsonism plus syndromes. Secondary parkinsonism is caused by structural, toxic, metabolic, or infectious mechanisms. Among structural causes, intracranial neoplasms are a rare cause of secondary parkinsonism. Moreover, there are almost never case reports with intracranial space-occupying lesions resulting in parkinsonism associated with rapid cognitive impairment. Therefore, we report herein a 37-year-old woman diagnosed with papillary meningioma who presented with parkinsonism associated with rapidly progressive cognitive impairment mimicking diffuse Lewy body disease.


Assuntos
Adulto , Neoplasias Encefálicas , Demência , Feminino , Humanos , Doença por Corpos de Lewy , Meningioma , Doença de Parkinson Secundária , Transtornos Parkinsonianos
9.
Rev. Soc. Peru. Med. Interna ; 25(4): 183-187, oct.-dic. 2012. tab
Artigo em Espanhol | LILACS (Américas), LIPECS | ID: lil-673495

RESUMO

Objetivo: Describir las características clínicas y epidemiológicas de los pacientes con enfermedad de Parkinson atípico. Material y métodos: El estudio fue descriptivo y retrospectivo. Se incluyó todos los pacientes con diagnóstico de enfermedad de Parkinson atípico que recibieron atención médica en el Hospital Nacional EsSalud Edgardo Rebagliati Martins de Lima, de cuyas historias clínicas se extrajo la información. Resultados. Se incluyó a 41 pacientes con diagnóstico de Parkinson atípico de los cuales la mayor frecuencia fueron pacientes con la parálisis supranuclear progresiva (PSP) seguidos de atrofia multisistémica (AMS), degeneración ganglionar corticobasal (DGCB) y demencia por cuerpos de Lewy (DCL). Hubo predominio de sexo masculino en pacientes con PSP y de sexo femenino en pacientes con AMS. Todos los pacientes con PSP presentaron un cuadro progresivo, edad de inicio mayor o igual a 40 años y parálisis supranuclear de la mirada vertical; todos los pacientes con AMS presentaron rigidez y la mayoría inestabilidad postural y ataxia de la marcha como características más frecuentes; todos los pacientes con DGCB presentaron un curso crónico progresivo y asimetría al inicio; finalmente, todos los pacientes con DCL presentaron un deterioro cognitivo progresivo de suficiente magnitud para interferir con las funciones normales sociales u ocupacionales y fluctuaciones en la función cognitiva con variaciones pronunciadas en la atención y alerta. Conclusión: Las características clínicas de las entidades catalogadas como parkinsonismo atípico son variadas y a veces con diferencias muy sutiles en cada uno de ellos; por tanto, establecer el diagnóstico correcto a veces resulta difícil.


Purpose: Describe the clinical and epidemiological characteristics in patients with atypical parkinsonism. Methods. The present study was descriptive and retrospective. It included all patients with atypical parkinsonian syndrome: progressive supranuclear palsy (PSP), corticobasal degeneration (CBD), multiple system atrophy (MSA) and dementia with Lewy bodies (DLB) that were attended in the Edgardo Rebagliati Martins Hospital, Lima. All data was collected from the clinical records. Results: There were 41 patients with atypical parkinsonism; the most frequent diagnosis was PSP followed by AMS, DGCB and finally DCL. Most PSP patients were males; otherwise, most AMS patients were females. All PSP patients had a progressive disease, age of onset ¡Ý 40 year-old and supranuclear palsy of vertical gaze. All AMS patients had rigidity, postural instability and ataxic gait as frequent characteristics. All DGCB patients had a chronic progressive course and asymmetry at onset. Finally patients with DCL had a progressive cognitive deterioration that interfere with normal social or occupational functions. Conclusion: The clinical characteristics of patients with an atypical parkinsonism syndrome were diverse and sometimes with few differences. So, to establish a correct diagnosis is difficult in some cases.


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Atrofia de Múltiplos Sistemas , Doença de Parkinson , Doença por Corpos de Lewy , Paralisia Supranuclear Progressiva , Transtornos Parkinsonianos , Epidemiologia Descritiva , Estudos Retrospectivos
10.
Psicofarmacologia (B. Aires) ; 12(73): 23-34, apr. 2012.
Artigo em Espanhol | LILACS (Américas) | ID: lil-653245

RESUMO

Como es sabido, la enfermedad de Parkinson suele presentar una evolución crónica, prolongada, e insidiosa. Para la cual aún no se disponen de terapéuticas efectivas que curen a dicha enfermedad, si no se posee un arsenal de fármacos (agonistas dopaminérgicos) capaces de mitigar los síntomas, mejorar y prolongar la calidad de vida y enlentecer el propio desarrollo de la enfermedad, que lleva hacia un deterioro profundo de la motricidad, funcionalidad y de las funciones neurocognitivas. También es sabida la asociación de la enfermedad de Parkinson con la demencia por la misma enfermedad. Pero a lo largo de ella, con o sin demencia, se suelen presentar en una proporción importante, una serie de síntomas asociados neuropsiquiátricos (NP), y neuroconductuales (NC) que hay que diferenciar si son producto de la propia enfermedad de Parkinson, o son desencadenados por el tratamiento. Algunos de estos síntomas asociados, los más importantes en cuanto a su frecuencia y gravedad sobre todo asociados a demencia son, depresión, excitación psicomotriz, ideación patológica, delirios, alucinaciones visuales, síndrome confusional (delirium), trastornos del sueño, ansiedad, apatía. Estos síntomas agravan la evolución de la propia enfermedad de Parkinson y la demencia asociada haciendo que su pronóstico se torne más desfavorable, y más deteriorante, afectando también a los cuidadores y alterando la calidad de vida del paciente y su entorno. En este trabajo me propongo dar una noción básica de dichos trastornos para su rápido reconocimiento y tratamiento, teniendo en cuenta la posible polifarmacia en estos pacientes, con las implicancias de las interacciones farmacológicas. La rápida resolución de estos síntomas asociados a la EP, con o sin demencia redundará en un menor deterioro funcional del paciente, mejorando su pronóstico y la calidad de vida del propio paciente y sus cuidadores.


Throughout the progression of Parkinson's disease, whether or not with dementia, a series of associated neuropsychiatric and neurobehavioral symptoms may appear, such as depression, anxiety, psychomotor agitation, delirium, visual hallucinations, confusional syndrome (delirium), sleep disorders, apathy, which aggravate the patients' prognosis and accelerate their overall deterioration and the quality of life of them and the people around them. The prompt identification and management of these associated neuropsychiatric and neurobehavioral symptoms, considered in conjunction with the possible pharmacological interactions among polymedicated patients, shall result in the patients' better quality of life and a more favorable prognosis.


Assuntos
Humanos , Agonistas de Dopamina/uso terapêutico , Qualidade de Vida/psicologia , Demência/patologia , Demência/terapia , Diagnóstico Precoce , Doença de Parkinson/psicologia , Doença de Parkinson/terapia , Doença por Corpos de Lewy/terapia , Manifestações Neurocomportamentais
11.
Sci. med ; 20(2)abr.-jun. 2010. tab
Artigo em Português | LILACS (Américas) | ID: lil-567145

RESUMO

Objetivos: a presente revisão descreve aspectos clínicos relacionados às diferentes síndromes demenciais, objetivando tornar comum, no meio médico, o conhecimento das nuanças que permeiam o diagnóstico diferencial dessas afecções. Fonte de Dados: foi realizada uma revisão da literatura através das bases de dados Medline, Ovid e Scopus até outubro de 2009, assim como de livros-texto. Artigos com enfoque na fisiopatogenia e na patologia não foram priorizados, tendo em vista os objetivos deste estudo. Síntese dos Dados: este artigo revisa aspectos dealgumas síndromes demenciais reversíveis e irreversíveis, como Doença de Alzheimer e Demência Vascular, enfocando principalmente as características clínicas e diagnósticas que as tornam entidades distintas. Conclusões: a literatura sugere que o processo diagnóstico das síndromes demenciais assenta-se fundamentalmente na clínica, priorizando uma avaliação rigorosa do estado mental. Entretanto, a avaliação por neuroimagem e exames laboratoriais tem participação considerável em determinar a causa subjacente ao quadro demencial, revelando peculiaridades que podem nortear o diagnóstico diferencial. Diagnosticar diferentes etiologias é importante para o prognóstico e conduta terapêutica específica.


Aims: This review describes the clinical aspects related to different dementia syndromes, aiming to become common in the medical , the knowledge of the nuances that permeate the differential diagnosis of these disorders. Data Source: A review of literature published up to October 2009 was conducted on Medline, Ovid, and Scopus databases, as well as on textbooks. Articles that focused on the pathogenesis and pathology were not prioritized, given the objectives of this study. Summary of the Findings: This article reviews some aspects of reversible and irreversible dementia syndromes, such as Alzheimer?s disease and Vascular Disease, focusing on the clinic and diagnostic features that make them distinct entities. Conclusions: The literature suggests that the diagnostic process of dementia syndromes is based mainly on clinical practice, prioritizing a rigorous assessment of mental status. However, neuroimaging evaluation and laboratory tests have considerable input in determining the underlying cause of dementia, revealing peculiarities that can guide the differential diagnosis. The diagnosis of different etiologies is important to the prognosis and the specific therapeutic approach.


Assuntos
Humanos , Masculino , Feminino , Doença de Alzheimer , Demência Vascular , Diagnóstico Diferencial , Demência/diagnóstico , Doença por Corpos de Lewy
12.
Mediciego ; 16(1)mar. 2010.
Artigo em Espanhol | LILACS (Américas) | ID: lil-547972

RESUMO

Se presenta un caso de dos años de evolución con síntomas principales de incontinencia urinaria, alucinaciones visuales llamativas, pérdida de la conciencia transitoria, dificultad para reconocer el lugar, rigidez muscular con inestabilidad en la marcha y fluctuaciones del rendimiento cognitivo en el transcurso del día. Se concluye que coincide con los criterios.


A case of two years of evolution that fit with the diagnoses criteria of Dementia with Lewy bodies (DLB) is presented being the main symptoms urinary incontinence, showy visual allucinations, loss of transitory consciousness, difficulty to recognize place, muscular rigidity with instability to walk and fluctuations of the mental performance as day went by.


Assuntos
Humanos , Feminino , Idoso de 80 Anos ou mais , Doença por Corpos de Lewy/diagnóstico
13.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wprim-46169

RESUMO

Psychosis in patients with dementia contributes substantially to patient morbidity and caregiver distress. The concept of psychosis of Alzheimer's disease (AD) and other types of dementia is developed with respect to prevalence, incidence, clinical characteristics, clinical course, and potential response to treatment. This article provides an overview of concept of psychosis in dementia. Published prevalence estimates of psychosis in patients with AD range from 10 to 73% within clinical populations. There is a continuing persistence of psychotic symptomatology among people with AD;most patients with psychosis continue to fulfill criteria for psychosis of dementia over at least 3 months, and over a half may have psychotic symptoms persist over a year. Among people with AD who have no psychotic symptoms there appears to be an annualized incidence of psychosis of about 20% in outpatients, and a much higher rate in nursing home patients. Frontal hypometabolism and greater frontal neuropsycological deficits occur in AD patients with psychosis in comparison to those without. There is some evidence that psychotic symptoms improve modestly with antipsychotic medication treatment, although optimal treatment guidelines have been elusive. The characteristics of psychosis in Parkinson's disease, Lewy body dementia, frontotemporal dementia and vascular dementia were also reviewed. Conclusively, further research to support the validity of a syndrome of psychosis in various types of dementia, as well as AD is needed.


Assuntos
Doença de Alzheimer , Cuidadores , Demência , Demência Vascular , Demência Frontotemporal , Humanos , Incidência , Doença por Corpos de Lewy , Casas de Saúde , Pacientes Ambulatoriais , Doença de Parkinson , Prevalência , Transtornos Psicóticos
14.
Acta méd. (Porto Alegre) ; 30: 530-537, 2009.
Artigo em Português | LILACS (Américas) | ID: lil-546773

RESUMO

As síndromes parkinsoninas, em especial a Doença de Parkinson são bastante presentes na prática clínica do neurologista, geriatra e clínico geral. Suas manifestações clínicas são bastante conhecidas; entretanto uns grandes números de situações enfermidade podem cursar com quadros semelhantes e, muitas vezes de difícil diagnóstico. Messes artigo, são abordadas as principais causas de síndromes parkinsonianas, com orientações no que tange ao seu diagnóstido, aspectos clínicos e prognóstico.


Assuntos
Humanos , Masculino , Feminino , Diagnóstico Diferencial , Doença por Corpos de Lewy , Atrofia de Múltiplos Sistemas , Transtornos Parkinsonianos , Paralisia Supranuclear Progressiva
16.
Rev. méd. Urug ; 24(3): 195-202, sept. 2008. ilus
Artigo em Espanhol | LILACS (Américas) | ID: lil-501667

RESUMO

El objetivo de esta revisión es poner al día el conocimiento acerca de una patología degenerativa que está considerada como la segunda causa de demencia, luego de la enfermedad de Alzheimer, en los centros que realizan anatomía patológica de modosistemático. Fue subdiagnosticada del punto de vista clínico en todo el mundo, hasta que recientemente se revisaron sus criterios diagnósticos y anatomopatológicos. Es altamenteprobable que en nuestro medio permanezca subdiagnosticada.Este hecho, sumado a su peculiar y grave evolución, justifica su revisión y puesta al día. Se deben considerar, además, las dificultades que los lectores uruguayos tenemos en torno alacceso a las fuentes originales. Se usaron artículos a texto completo y como fuentes complementarias PubMed y Proquest. Se revisaron revistas científicas con textos en inglés, se consideró la importancia del autor oautores en el tema, así como la relevancia de la revista. Los artículos abarcan un período amplio que se extiende desde fines de la década de 1990 hasta el año 2007. Se hace especial hincapié en los consensos más recientes, considerándolos claves para el diagnóstico clínico.


This review aims to update knowledge about a degenerative pathology that is currently regarded as the secondcause of dementia –Alzheimer being first–, at centers where anatomopathology is performed systematically. From the clinical point of view, this disease was underdiagnosedworld-wide, until recently, when its diagnostic and anatomopathologicalcriteria were reviewed. It is highly probable that it is still underdiagnosed in our country. For this reason, and given its peculiar and serious evolution,it is worth reviewing and updating. Likewise, we need to bear in mind the difficulties we, Uruguayan readers,face when it comes to having access to original sources. We used full text articles, PubMed, and Proquestas complementary sources. We reviewed scientific journalsin English, based on the relevance of the authors and the journals on the topic. The articles covered a broadrange of time, from the late 90’s until 2007. We concentrated on the most recent consensus, regarding them askey for the clinical diagnosis of the disease.


O objetivo desta revisão é atualizar o conhecimento sobre uma patología degenerativa que é considerada nos centros que realizam anatomía patológica de modo sistemático,como a causa de demência mais importante depois da doença de Alzheimer. Até recentemente, quando oscritérios diagnósticos e de anatomia patológica foram revisados, esta entidade era clinicamente sub-diagnosticada. É muito provável que no nosso meio isto continue acontecendo.Este fato, associado a sua evolução, grave e peculiar, justifica uma revisão e atualização. Devem-se considerartambém as dificuldades, no nosso meio, de acesso a fontes originais. Neste trabalho foram incluídos artigos a textocompleto e como fontes complementares informação de PubMed e Proquest .Foram revisadas revistas científicas com textos em inglês, considerando a importância do autor ou autoresno tema, bem como a relevância da revista. Os artigos selecionados foram publicados no período compreendidoentre o final da década de 1990 e 2007. Foram especialmente considerados os consensos mais recentes comoinformação fundamental para o diagnóstico clínico.


Assuntos
Alucinações , Corpos de Lewy , Doença por Corpos de Lewy
17.
An. Fac. Med. (Perú) ; 69(3): 157-163, jul.-sept. 2008. graf, tab
Artigo em Espanhol | LILACS (Américas), LIPECS | ID: lil-564594

RESUMO

Objetivos: Analizar los efectos de los inhibidores de colinesterasas (ICE) donepezilo, rivastigmina y galantamina en el tratamiento de demencia con cuerpos de Lewy (DCL) y demencia de la enfermedad de Parkinson (DEP). Diseño: Estudio tipo ensayo abierto. Lugar: Servicio de Neurología, Hospital Militar Central (HMC), y Unidad de Diagnóstico de Deterioro Cognitivo y Prevención de Demencia, Clínica Internacional. Participantes: Pacientes con demencia asociada a cuerpos de Lewy y demencia de la enfermedad de Parkinson. Intervenciones: Las mediciones de eficacia en 33 pacientes con diagnóstico de DCL y DEP se realizó con el Mini-Mental State Examination (MMSE), Alzheimer Disease Assessment Scale cognitive subscale (ADAS-cog), Alzheimer's Disease Cooperative Study-Clinical Global Impression of Change(ADCS-CGIC), Alzheimer's Disease Cooperative Study-Activities of Daily Living Inventory (ADCS-ADL), Neuro-Psychiatry Inventory (NPI), Prueba de dibujo de Reloj de Manos (PDR-M) y la Unified Parkinson's Disease Rating Scalemotor subscale (UPDRS-part III). Principales medidas de resultados: Síntomas cognitivos, funcionamiento global y actividades de vida diaria de los pacientes. Resultados: Diecisiete pacientes fueron tratados con rivastigmina, 9 con galantamina y 7 con donepezilo. Luego de 6 meses de tratamiento, los pacientes en tratamiento con rivastigmina mejoraron en 1,39 puntos en ADAS-cog respecto de su medición basal, mientras que los pacientes tratados con donepezilo y galantamina no mostraron cambios (cambios < 0,2 puntos). Respecto al ADCS-ADL, los pacientes tratados con rivastigmina, donepezilo y galantamina demostraron disminución de 0,42, 0,58 y 0,75 puntos, respectivamente. En el MMSE, los pacientes tratados con rivastigmina y donepezilo no mostraron cambios y los pacientes tratados con galantamina tuvieron una disminución promedio de 1,19 puntos. No hubo diferencias significativas en la incidencia de síntomas parkinsonianos en los tres grupos ...


Objectives: To analyze the effects of cholinesterase inhibitors (CHEIs) prescribed for treatment of dementia with Lewy bodies (DLB) and dementia associated with Parkinson's disease (PDD). Design: Open essay study. Setting: Neurology Service, Hospital Militar Central, and Cognitive Deterioration Diagnosis Unit and Dementia Prevention, Clinica Internacional. Participants: Patients with dementia associated to Lewy bodies and dementia associated with Parkinson's disease. Interventions: Outcome measures included the Mini-Mental State Examination (MMSE), the Alzheimer Disease Assessment Scale cognitive subscale (ADAS-cog), Alzheimer's Disease Cooperative Study-Clinical Global Impression of Change (ADCS-CGIC), Alzheimer's Disease Cooperative Study-Activities of Daily Living Inventory (ADCS-ADL), Neuro-Psychiatry Inventory (NPI), Ten Point Clock-Drawing Test (CDT) andUnified Parkinson's Disease Rating Scale-motor subscale (UPDRS-part III). Main outcome measures: Patients' cognitive symptoms, global functionand daily life activities. Results: Seventeen patients were treated with rivastigmine, nine with galantamine and seven with donepezil. At six months, rivastigmine-treated patients improved by 1,39 points from baseline on the ADAS-cog, while donepezil and galantamine treated patients showed 'no change" (changes of < 0,2 points). On the ADCS-ADL, patients treated with rivastigmine, donepezil and galantamine showed decreases of 0,41, 0,68 and 0,86 points, respectively. On the MMSE, donepezil and rivastigmine-treated patients showed 'no change' and galantamine-treated patients showed a mean decrease of 1,19 points. The difference with regard to the incidence of parkinsonian symptoms as adverse events was not reflected in significant differences in UPDRS motor scores between the three groups. Side effects were similar in the three treatment groups. Conclusions: Cholinesterase inhibitors may be of benefit for cognitive impairments with impact on global function ...


Assuntos
Humanos , Demência , Doença de Parkinson , Doença por Corpos de Lewy , Inibidores da Colinesterase
18.
Artigo em Inglês | IMSEAR (Sudeste Asiático), GHL | ID: sea-45205

RESUMO

Dementia represents the most common neurodegenerative disorders affecting approximately 5% of the elderly population over age 65 years. At present, different forms of dementia are distinguished, including Alzheimer's disease (AD), dementia with Lewy bodies, frontotemporal dementia, and dementia secondary to diseases, such as AIDS dementia. Unlike AD, these atypical dementias are often associated with neurological symptoms, reflecting the localization of the degenerative process rather than the nature of the underlying histopathology. The present article provides an overview of the clinical evaluation of patients with atypical dementia and reviews distinguishing features of atypical dementias that may be confused with AD. The laboratory and imaging evaluation of various types of dementias are described. Current practice guidelines and practice parameters are reviewed as relevant for primary care practitioner.


Assuntos
Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/diagnóstico , Demência Vascular/diagnóstico , Diagnóstico Diferencial , Humanos , Doença por Corpos de Lewy/diagnóstico , Doença de Parkinson/complicações
19.
Med. lab ; 12(5/6): 211-219, jun. 2006. ilus, tab
Artigo em Espanhol | LILACS (Américas) | ID: lil-473060

RESUMO

Un esquema completo para el estudio de la demencia incluye una serie de exámenes del laboratorio clínico. Muchos de éstos son pruebas de rutina, enfocadas a descartar enfermedades reversibles asociadas con un déficit cognitivo o al delirium. Una vez establecido el diagnóstico de demencia y se hayan descartado las causas tratables, el diagnóstico diferencial se vuelve más reducido y se incluyen las enfermedades neurodegenerativas y la demencia vascular. El clínico, usualmente puede realizar el diagnóstico de la enfermedad de Alzheimer, de la demencia con cuerpos de Lewy o de la demencia vascular, utilizando los hallazgos del examen físico o los datos de las neuroimágenes. Sin embargo, el estándar de oro para el diagnóstico definitivo de la demencia sigue siendo el examen neuropatológico en la autopsia. Para el futuro, las microseries de ADN y ARN y la técnicas proteómicas darán un mejor entendimiento en la patogénesis de la demencia, aportando diagnósticos más exactos y mejores herramientas para el tratamiento.Palabras clave: laboratorio, demencia, enfermedad de Alzheimer, demecia con cuerpos de Lewy.


Assuntos
Doença de Alzheimer , Demência , Corpos de Lewy , Doença por Corpos de Lewy
20.
Niterói; UFF; 2006. 33 p.
Monografia em Português | LILACS (Américas) | ID: lil-557454

RESUMO

As demências são doenças mentais caracterizadas por transtornos de conduta graves, cuja sisntomatologia principal predominante é uma deterioração progressiva do intelecto e devido ao expressivo aumento da expectativa de vida na população mundial vem aumentando o número de pacientes atendidos, sendo que a prevalência da demência duplica cada ano após os 65 anos de idade...Concluimos fazendo uma especificação das alterações na RM que caracterizam a cada uma destas quatro demências, destacando também que estes dados junto a clínica podem ter uma importante contribuição no diagóstico das demências degenerativas.


Assuntos
Doença de Alzheimer , Demência , Demência Vascular , Doença por Corpos de Lewy , Espectroscopia de Ressonância Magnética
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