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 25, 2020]
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 ====== Lewy Body Dementia (LBD) ======
+{{INLINETOC}}
 ===== Primer =====
 **Lewy Body Dementia/Disease** (LBD) also known as **Dementia with Lewy Bodies** (DLB), is a neurodegenerative disorder associated with abnormal deposits of a protein called alpha-synuclein in the brain. It is characterized by progressive cognitive impairment (with early changes in complex attention and executive function rather than learning and memory), recurrent complex visual hallucinations, rapid eye movement (REM) sleep behavior disorder, depression, and/or delusions. LBD is one of the most common causes of dementia.
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 ==== Neuroimaging ====
-A diagnostically suggestive feature is low striatal dopamine transporter uptake on [[neurology:investigations:neuroimaging:spect|]] or positron emission tomography (PET) scan. See also: [[https://ebmh.bmj.com/content/21/2/61|Surendranathan, A., & O’brien, J. T. (2018). Clinical imaging in dementia with Lewy bodies. Evidence-based mental health, 21(2), 61-65.]]
+A diagnostically suggestive feature is low striatal dopamine transporter uptake on [[neurology:spect]] or positron emission tomography (PET) scan. See also: [[https://ebmh.bmj.com/content/21/2/61|Surendranathan, A., & O’brien, J. T. (2018). Clinical imaging in dementia with Lewy bodies. Evidence-based mental health, 21(2), 61-65.]]
 ==== Antipsychotics ====
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 ===== 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>