Book contents
- Frontmatter
- Contents
- Contributors
- Foreword
- Acknowledgements
- Biographical note on F. H. Lewy
- Abbreviations
- Group photograph
- Introduction
- Part one Clinical issues
- 1 The clinical diagnosis and misdiagnosis of Lewy body dementia
- 2 The nosological status of Lewy body dementia
- 3 Putative clinical and genetic antecedents of dementia associated with Parkinson's disease
- 4 Clinical features of patients with Alzheimer's disease and Lewy bodies
- 5 The nature of the cognitive decline in Lewy body dementia
- 6 Noncognitive symptoms in Lewy body dementia
- 7 Hallucinations, cortical Lewy body pathology, cognitive function and neuroleptic use in dementia
- 8 Neuropsychological aspects of Lewy body dementia
- 9 The neuroanatomical basis of cognitive deficits in Lewy body dementia
- 10 The clinical and functional imaging characteristics of parkinsonian dementia
- 11 Positron emission tomography findings in Parkinson's disease and Lewy body dementia
- 12 Clinical features of diffuse Lewy body disease in the elderly: analysis of 12 cases
- 13 Senile dementia of Lewy body type – clinical features and prevalence in neuropathological postmortems
- 14 Lewy body dementia in clinical practice
- Résumé of treatment workshop sessions
- Part two Pathological issues
- Part three Treatment issues
- Appendices
- Index
- Plate section
13 - Senile dementia of Lewy body type – clinical features and prevalence in neuropathological postmortems
from Part one - Clinical issues
Published online by Cambridge University Press: 06 July 2010
- Frontmatter
- Contents
- Contributors
- Foreword
- Acknowledgements
- Biographical note on F. H. Lewy
- Abbreviations
- Group photograph
- Introduction
- Part one Clinical issues
- 1 The clinical diagnosis and misdiagnosis of Lewy body dementia
- 2 The nosological status of Lewy body dementia
- 3 Putative clinical and genetic antecedents of dementia associated with Parkinson's disease
- 4 Clinical features of patients with Alzheimer's disease and Lewy bodies
- 5 The nature of the cognitive decline in Lewy body dementia
- 6 Noncognitive symptoms in Lewy body dementia
- 7 Hallucinations, cortical Lewy body pathology, cognitive function and neuroleptic use in dementia
- 8 Neuropsychological aspects of Lewy body dementia
- 9 The neuroanatomical basis of cognitive deficits in Lewy body dementia
- 10 The clinical and functional imaging characteristics of parkinsonian dementia
- 11 Positron emission tomography findings in Parkinson's disease and Lewy body dementia
- 12 Clinical features of diffuse Lewy body disease in the elderly: analysis of 12 cases
- 13 Senile dementia of Lewy body type – clinical features and prevalence in neuropathological postmortems
- 14 Lewy body dementia in clinical practice
- Résumé of treatment workshop sessions
- Part two Pathological issues
- Part three Treatment issues
- Appendices
- Index
- Plate section
Summary
Summary
Though the history of Lewy body related diseases started in Germany, German neurology and psychiatry still ignore the existence of dementias with cortical Lewy bodies (LB). In order to estimate the proportion of senile dementia of the Lewy body type (SDLBT) in neuropathological postmortems in Germany, we screened all brains (n = 273) of adult patients, who died in 1991 and were examined by one neuropathologist at the University Medical Center in Mainz, Germany. A multi-stage approach to detecting LBs was used with final detection by ubiquitin immunohistochemistry.
Four cases were discovered (1.5% of all cases and 4.3% of demented or confused patients). Thirty cases from the series had a neuropathological diagnosis of Alzheimer's disease (AD). All four cases with cortical LBs showed additional neurofibrillary pathology. In other years, independent of this study, solitary cases attracted attention in which no additional neurofibrillary pathology was detected. The clinical spectrum and its nosological implications are discussed and a diagnostic separation between a condition with ‘pure’ cortical Lewy bodies and one representing a combination with Alzheimer pathology is suggested.
Introduction
In 1912 the history of Lewy body (LB)-related diseases started in Germany with Friederich H. Lewy's contribution to Lewandowsky's Handbuch der Neurologie (Lewy, 1912). In this chapter, concerning the pathology of paralysis agitans, Lewy gave the first description of ‘classical’ (‘brainstem-type’) and ‘serpiginous’ LBs in the neurons of the dorsal vagal nucleus. Lewy himself did not mention the substantia nigra in particular, even when he described the occurrence of LBs in other brainstem nuclei in his famous book Die Lehre vom Tonus und der Bewegung (Lewy, 1923).
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- Information
- Dementia with Lewy BodiesClinical, Pathological, and Treatment Issues, pp. 161 - 170Publisher: Cambridge University PressPrint publication year: 1996