Differences

Last edited on February 5, 2024

This shows you the differences between two versions of the page.

--- geri:dementia:lewy-body [on April 11, 2019]
+++ geri:dementia:lewy-body [on April 17, 2019]
@@ Line 84: / Line 84: @@
 ==== Lewy Body or Parkinsons's? ====
-<callout type="info" title="LBD patients present with memory impairments first, where as PD patients present with motor impairments first" icon="true">
+<callout type="info" title="Is It Lewy Body or Parkinsons's?" icon="true">
-LBD should be diagnosed when dementia occurs before or concurrently with parkinsonism. The term Parkinson disease dementia (PDD) should be used to describe dementia that occurs in the context of well-established Parkinson disease. In a practice setting the term that is most appropriate to the clinical situation should be used and generic terms such as Lewy body disease are often helpful. In research studies in which distinction needs to be made between LBD and PDD, the existing 1-year rule between the onset of dementia and parkinsonism continues to be recommended.
+LBD patients present with memory impairments first, where as PD patients present with motor impairments first. LBD should also be diagnosed when dementia occurs before or concurrently with parkinsonism. The term Parkinson disease dementia (PDD) should be used to describe dementia that occurs in the context of well-established Parkinson disease. In a clinical setting the term that is most appropriate to the clinical situation should be used and generic terms such as Lewy Body Disease are often helpful. In research studies in which distinction needs to be made between LBD and PDD, the existing 1-year rule between the onset of dementia and parkinsonism continues to be recommended.
 </callout>
@@ Line 102: / Line 102: @@
 ===== Treatment =====
 ==== Pharmacotherapy ====
-<callout type="danger" title="Typical antipsychotics are contraindicated in LBD" icon="true">A severe sensitivity reaction occurs in an estimated 25-50% of LBD patients administered typical antipsychotic drugs (especially haloperidol) in the usual dose range.[([[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3913181/|Boot, B. P., McDade, E. M., McGinnis, S. M., & Boeve, B. F. (2013). Treatment of dementia with Lewy bodies. Current treatment options in neurology, 15(6), 738-764.]])] This results in cognitive impairment, sedation, increased/irreversible acute onset of parkinsonism, or symptoms resembling [[meds:side-effects:nms|neuroleptic malignant syndrome]]. If an antipsychotic must be used, then low potency atypical antipsychotics like clozapine or quetiapine should be used.[([[https://www.lbda.org/go/er|Lewy Body Dementia Association: Emergency Room Treatment of Psychosis]])]
+<callout type="danger" title="Typical antipsychotics are contraindicated in LBD" icon="true">A severe sensitivity reaction occurs in an estimated 25-50% of LBD patients administered typical antipsychotic drugs (especially haloperidol) in the usual dose range.[([[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3913181/|Boot, B. P., McDade, E. M., McGinnis, S. M., & Boeve, B. F. (2013). Treatment of dementia with Lewy bodies. Current treatment options in neurology, 15(6), 738-764.]])] This results in cognitive impairment, sedation, increased/irreversible acute onset of parkinsonism, or symptoms resembling [[meds:antipsychotics:nms-neuroleptic-malignant-syndrome|neuroleptic malignant syndrome]]. If an antipsychotic must be used, then low potency atypical antipsychotics like clozapine or quetiapine should be used.[([[https://www.lbda.org/go/er|Lewy Body Dementia Association: Emergency Room Treatment of Psychosis]])]
 </callout>