Saturday, December 30, 2006

Lewy Body Dementia - Symptoms

Due to length will only publish part the rest will follow tomorrow remember credit is: visit them.

LBD Symptoms
Lewy body dementia symptoms and diagnostic criteria

Every person with LBD is different and will manifest different degrees of the following symptoms. Some will show no signs of certain features, especially in the early stages of the disease. Symptoms may fluctuate as often as moment-to-moment, hour-to-hour or day-to-day. NOTE: Some patients meet the criteria for LBD yet score in the normal range of some cognitive assessment tools. The Mini-Mental State Examination (MMSE), for example, cannot be relied upon to distinguish LBD from other common syndromes.

The latest clinical diagnostic criteria for LBD groups symptoms into three types:
Central feature
Progressive dementia

Deficits in attention and executive function are typical. Prominent memory impairment may not be evident in the early stages.
Core features:

* Fluctuating cognition with pronounced variations in attention and alertness.
* Recurrent complex visual hallucinations, typically well formed and detailed.
* Spontaneous features of parkinsonism.

Suggestive features:

* REM sleep behavior disorder (RBD), which can appear years before the onset of dementia and parkinsonism.
* Severe sensitivity to neuroleptics occurs in up to 50% of LBD patients who take them.
* Low dopamine transporter uptake in the brain's basal ganglia as seen on SPECT and PET imaging scans. (These scans are not yet available outside of research settings.)

Supportive features:

* Repeated falls and syncope (fainting).
* Transient, unexplained loss of consciousness.
* Autonomic dysfunction.
* Hallucinations of other modalities.
* Visuospatial abnormalities.
* Other psychiatric disturbances.

A clinical diagnosis of LBD can be probable or possible based on different symptom combinations.

A probable LBD diagnosis requires either:

* Dementia plus two or more core features, or
* Dementia plus one core feature and one or more suggestive features.

A possible LBD diagnosis requires:

* Dementia plus one core feature, or
* Dementia plus one or more suggestive features.

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