Three Main Symptoms Of LBD:
What Are The 3 Main Symptoms?
1. Fluctuating alertness and/or cognition
2. Recurrent visual hallucinations
3. Parkinson's Disease symptoms.
Two of the above symptoms, along with signs of dementia, give a probable diagnosis of Lewy Body Dementia. One of these symptoms plus dementia gives a possible diagnosis.
In this section we look at each of the symptoms, starting with that key word: dementia.
Dementia is a process whereby the person becomes progressively confused. The earliest signs are usually memory problems, changes in their way of speaking, such as forgetting words, and personality problems. Cognitive symptoms of dementia include poor problem solving, difficulty with learning new skills and impaired decision making.
Other causes of dementia should be ruled out first, such as alcoholism, overuse of medication, thyroid or metabolic problems. Strokes can also cause dementia. If these reasons are ruled out then the person is said to have a degenerative dementia. Alzheimer's disease is one of the most common causes of dementia.
Fluctuations in cognition will be noticeable to those who are close to the person with LBD, such as their partner. At times the person will be alert and then suddenly have acute episodes of confusion. These may last hours or days. Because of these fluctuations it is not uncommon for it to be thought that the person is "faking". This fluctuation will not be related to the well-known "sundowning" of Alzheimer's. In other words, there is no specific time of day when confusion can usually be seen to occur.
Hallucinations are usually, but not always, visual and often are more pronounced when the person is most confused. They are not necessarily frightening to the person.
Parkinson's takes the form of changes in gait; the person may shuffle or walk stiffly. There may also be frequent falls.
Every person with Lewy Body Dementia is different and will manifest different degrees of the above symptoms. Some will show no signs of certain symptoms, especially in the early stages of the disease.
Rem Sleep Behavior Disorder (RBD) is often noted in persons with Lewy Body Dementia. During periods of REM sleep, the person will move, gesture and/or speak. There may be more pronounced confusion between the dream and waking reality when the person awakens.
Another significant symptom, which occurs, is sensitivity to neuroleptics. Medications can worsen the Parkinson's symptoms or increase the confusion. Neuroleptic Malignancy Syndrome, a life-threatening illness, has been reported for persons with Lewy Body Dementia. For these reasons it is very important that the proper diagnosis is made and that healthcare providers are educated about the disease.
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