Rapid Review of 'Advanced(3)' Pearls on Parkinsonism for MRCP

Dementia in elderly:

1.       Alzheimer's disease(AD) ( lewy body present in 40%)

2.       Lewy body dementia(LBD)

LBD : additional features: ( for basic, see previous post)

• Executive dysfunction+Autonomic failure
• Impairment of  1. Judging distance 2. performing simple action
• Psychosis+ Non- visual hallucination also

LBD D/D:

• Idiopathic Parkinson's,
• MSA
• PSP
• Lead toxicity(Plumber)

LBD Dx:

• Confirm by 1. Postmortem   2. Cortical brain biopsy
• MRI: Hippocampal atrophy
• PET: Dynamic change ( not definitive test )

LBD Rx: 

• Rivastigmine

LBD prognosis: 

• Progressive
• Mean survival from Dx = 6 years