Case report

https://doi.org/10.20471/acc.2020.59.04.27

The Enigma of Lewy Body Dementia: a Case Report

Ivana Orlović orcid.org/0000-0003-2440-6729 ; Department of Psychiatry, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
Matija Bartolović ; Department of Psychiatry, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
Katarina Marušić ; Department of Psychiatry, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
Darko Vlahović orcid.org/0000-0002-4693-3450 ; Department of Psychiatry, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
Ines Šiško Markoš orcid.org/0000-0001-6425-0701 ; Department of Oncology and Nuclear Medicine, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
Dalibor Karlović ; Department of Psychiatry, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; Catholic University of Zagreb, Zagreb, Croatia; School of Dental Medicine, University of Zagreb, Zagreb, Croatia
Vjekoslav Peitl orcid.org/0000-0003-4163-6411 ; Department of Psychiatry, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; Catholic University of Zagreb, Zagreb, Croatia

Abstract

Lewy body dementia is a progressive neurodegenerative disease and is considered
to be the second most common cause of dementia in the elderly. Because of the complexity of clinical
presentation, it is often misdiagnosed and mistaken for other dementias, which may result in administering
inappropriate therapy, and thus worsening of the patient condition. We reviewed a case of a
71-year-old patient whose clinical presentation gradually occurred with complex visual hallucinations,
atypical extrapyramidal motor symptoms, fluctuating cognitive impairments with delirious episodes,
and oscillating syncope. Depressive mood, impaired daily functioning and sensitivity to antipsychotics
were also noted. Extensive diagnostic workup was performed with neuropsychological testing and use
of single-photon emission computerized tomography. Considering the clinical presentation and diagnostic
procedures performed, the diagnosis of Lewy body dementia was set and pharmacotherapy was
revised. We discuss the importance of taking overall clinical presentation and diagnostic treatment in
consideration and applying appropriate therapy to slow down the progression of the disease and exacerbation
of the patient’s psychological functions.

Keywords

Lewy body disease; Cognitive dysfunction; Hallucinations; Parkinsonian disorders; Cholinesterase inhibitors; Dementia

Hrčak ID:

255235

URI

https://hrcak.srce.hr/255235

Publication date:

1.12.2020.

Article data in other languages: croatian

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