Demenz mit lewy-körpern und parkinson-krankheit mit demenz: Zwei häufige demenzformen, die oft nicht erkannt werden.

Translated title of the contribution: Lewy body and parkinsonian dementia: Common, but often misdiagnosed conditions

Brit Mollenhauer, Hans Förstl, Günther Deuschl, Alexander Storch, Wolfgang Oertel, Claudia Trenkwalder

Research output: Contribution to journalReview articlepeer-review

45 Scopus citations

Abstract

Background: Dementia with Lewy-Bodies (DLB) and Parkinsonian Disease Dementia (PDD) are the two most common types of dementing neurodegenerative disease after Alzheimer's disease (AD). Both of these conditions are often diagnosed late or not at all. Methods: Selective literature review. Results: The severe cholinergic and dopaminergic deficits that are present in both DLB and PDD produce not only motor manifestations, but also cognitive deficits, mainly in the executive and visual-constructive areas, as well as psychotic manifestations such as visual hallucinations, delusions, and agitation. The intensity of these manifestations can fluctuate markedly over the course of the day, particularly in DLB. Useful tests for differential diagnosis include magnetic resonance imaging and electroencephalography; in case of clinical uncertainty, nuclear medical procedures and cerebrospinal fluid analysis can be helpful as well. Neuropathological studies have revealed progressive alpha-synuclein aggregation in affected areas of the brain. In DLB, beta-amyloid abnormalities are often seen as well. Conclusion: DLB should be included in the differential diagnosis of early dementia. If motor manifestations arise within one year (DLB), dopaminergic treatment should be initiated. On the other hand, patients with Parkinson disease should undergo early screening for signs of dementia so that further diagnostic and therapeutic steps can be taken in timely fashion, as indicated. Cholinesterase inhibitors are useful for the treatment of cognitive deficits and experiential/behavioral disturbances in both DLB (off-label indication) and PDD (approved indication).

Translated title of the contributionLewy body and parkinsonian dementia: Common, but often misdiagnosed conditions
Original languageGerman
Pages (from-to)684-691
Number of pages8
JournalDeutsches Arzteblatt
Volume107
Issue number39
DOIs
StatePublished - 1 Oct 2010
Externally publishedYes

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