Caused by an abnormal protein… Symptoms similar to other diseases
| ▲ Professor Park Ki-hyung (Photo = Courtesy of Gachon University Gil Hospital) |
[메디컬투데이=이재혁 기자] Lewy body dementia can show similar symptoms to Parkinson’s disease, so be careful not to confuse it. In both diseases, body movement is slow and gait is bad, but Lewy body dementia has little hand tremor.
Professor Park Gi-hyung of Gachon Gil University’s Department of Neurology explained that dementia with Lewy bodies and Parkinson’s disease are diseases caused by a protein called ‘alpha-synuclein’ which damages brain cells.
Dementia with Lewy bodies is a disease caused by the accumulation of abnormal protein clumps in the cerebral cortex and brainstem, resulting in damage to brain cells. It is known as the second most dementia after Alzheimer’s disease dementia.
Dementia with Lewy bodies is similar to but different from Parkinson disease. This is because Parkinson’s symptoms also appear in patients with dementia with Lewy bodies. However, there are differences from common Parkinson’s disease. Parkinson’s disease often begins with tremors on one side of the hand, often resulting in slow movements and a shrill gait. However, in many cases, the symptoms of Parkinson’s disease, Lewy body dementia, and hand tremor are not visible.
In addition, about 40% of patients with Parkinson’s disease suffer from dementia, but it appears more than a year after the onset of Parkinson’s disease. However, in dementia with Lewy bodies, the dementia symptoms appear first, followed by Parkinsonian symptoms, or appear almost simultaneously.
Also, dopamine, a treatment for Parkinson’s disease, is not effective for patients with dementia with Lewy bodies.
Professor Park said: ‘In the early stages of dementia with Lewy bodies, memory may be normal. However, as the disease progresses, memory gradually deteriorates,” he said. “It’s important to diagnose and treat dementia early because dementia medications may have a better effect than Alzheimer’s dementia.”
The representative symptoms of Lewy body dementia can be broadly divided into hallucinations, REM sleep behavior disorder, cognitive fluctuations, and parkinsonian symptoms. The so-called ‘vision’ of seeing the illusion is the most representative symptom.
When patients with Lewy body dementia experience hallucinations, they see very vivid hallucinations. Patients may describe hallucinations as seeing them in front of them, such as “a person wearing a black hat is trying to reach into his pockets.” If this is misunderstood as a mental illness and antipsychotic drugs are used, caution should be exercised as side effects such as the patient’s inability to move and lie down can occur.
Another symptom is REM sleep behavior disorder. REM sleep behavior disorder is a condition in which the content of a dream translates into action during sleep. For example, while dreaming about fighting, you may hit and injure the person sleeping next to you, or punch a wall and injure yourself.
The third symptom is that cognitive fluctuations intensify. Patients with these symptoms may appear empty during the day or take many naps. Therefore, if you often nap a lot and show a lot of distraction, you may suspect dementia with Lewy bodies.
Finally, the main symptom of Lewy body dementia is Parkinsonian symptoms. Parkinsonian symptoms of dementia with Lewy bodies are described above.
Professor Park said: ‘Dementia with Lewy bodies progresses very rapidly and, especially when accompanied by Alzheimer’s disease, can worsen faster, so accurate diagnosis and early treatment are needed.
Medical Today reporter Lee Jae-hyeok (dlwogur93@mdtoday.co.kr)
[저작권자ⓒ 메디컬투데이. 무단전재-재배포 금지]
