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Dementia in Clinical Practice

Editor(s): Giannakopoulos P. (Geneva) 
Hof P.R. (New York, N.Y.) 
Table of Contents
Vol. 24, No. , 2009
Section title: Lewy Body Dementia
Giannakopoulos P, Hof PR (eds): Dementia in Clinical Practice. Front Neurol Neurosci. Basel, Karger, 2009, vol 24, pp 107–113
(DOI:10.1159/000197889)

Dementia with Lewy Bodies: Clinical Diagnosis and Therapeutic Approach

Gold G.
Geneva University School of Medicine and Geneva University Hospitals, Geneva, Switzerland

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Abstract

Dementia with Lewy bodies is one of the most common dementias in the elderly after Alzheimer’sdisease. It can be recognized on the basis of several clinical characteristics including progressivedementia with marked slowing and fluctuations, persistent visual hallucinations and an extrapyramidalsyndrome. Several other clinical and imaging features are highly suggestive such as the presenceof rapid eye movement sleep disorder, severe sensitivity to neuroleptics and specificneuroimaging abnormalities. Therapeutic strategies include prescription of L-dopa and cholinesteraseinhibitors such as rivastigmine, and avoidance of anticholinergic medications and neuroleptics.Physicians who care for older people should have a heightened awareness of this entity in orderto diagnose it early, avoid mistaking it for delirium and initiate appropriate treatment.



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