Lewy Body Dementia

The most common type of dementia by far is Alzheimers dementia.  The second most common is Lewy Body dementia.  Features found in LBD but not Alzehimers include gait disturbances and psychiatric manifestations.

The gait disturbance in LBD is similar to that in Parkinson's disease.  Patients may shake, shuffle, or be stiff. 

Psychiatric disturbances include hallucinations, REM sleep disorders, delusions, and aggression.  Patients often have very poor tolerance of neuroleptic medications.  In these instances, neuroleptic medicaions make symptoms worse.

Cognitive and psychiatric disturbances usually are the first symptom followed by gait disturbances.  When gait disturbances are the first symptom, usually Parkinson's is diagnosed.  Treatments are similar in LBD and Parkinson's disease.  Rivastigmine and levodopa are sometimes used for symptom management in LBD.