Clinical analysis of 8 dementia with Lewy bodies / 中华神经科杂志

ABSTRACT

Objective To investigate the clinical features,diagnosis and treatment of dementia with Lewy bodies(DLB).Methods A clinical, neuropsychological ,neuroimaging and therapeutic analysis on 8 cases of clinically diagnosed dementia with Lewy bodies was conducted.Results Fluctuating cognition(FC) was the first symptom in all 8 patients,followed by persistent visual hallucinations and Parkinsonism. Patients showed moderate dementia and severe constructional disabilities .The ratings of FC were mild to moderate with scores 4-10(mean 7.4?2.1). The UPDRS scores ranged from 31 to 71 (mean 47.8?14.3). The polysomnography of the patient with REM sleep behavior disorder showed augmented submental muscle activity during REM and no EEG epileptiform activity. MRI or CT scans showed global brain atrophy in all 8 patients. SPECT of Sleep patient showed impaired striatal dopaminergic function . L-dopa and donepezil therapy were effective.Conclusions The main clinical features of DLB are fluctuating cognition, persistent visual hallucinations and extrapyramidal motor symptoms. The diagnosis relies on history and current symptoms, neuropsychological testing and findings of neuroimaging. L-dopa and cholinesterase-inhibitor drugs can improve mobility and cognitive symptoms in DLB.