Dementia with Lewy bodies studied with positron emission tomography.
OBJECTIVE
To report a case initially fulfilling the clinical criteria for probable Alzheimer disease, although later clinical features suggested dementia with Lewy bodies. Oxygen 15-labeled positron emission tomograms revealed a pattern of hypometabolism characteristic of Alzheimer disease. At post mortem, there was no evidence of the pathological features of Alzheimer disease, but diffuse cortical Lewy bodies were seen in the pigmented brainstem nuclei and cerebral cortex.


METHODS
A case report.


METHODS
Tertiary referral center.


METHODS
A 65-year-old white man presented with a 3-year history of memory loss and language difficulties.


RESULTS
Oxygen 15-labeled positron emission tomograms revealed hypometabolism in the frontal, temporal, and parietal lobes, more severe on the left than right. Metabolism in the left caudate was just outside the 95% reference range. Occipital metabolism was normal.


CONCLUSIONS
Positron emission tomographic studies have been reported to show occipital hypometabolism in dementia with Lewy bodies, in addition to the characteristic posterior bitemporal biparietal pattern of Alzheimer disease. We suggest that although this finding may favor a diagnosis of dementia with Lewy bodies, it is not necessary for diagnosis.
Dementia Research Group, Department of Clinical Neurology, Institute of Neurology and Division of Neurosciences, Imperial College School of Medicine, London, UK.
R J
RJ
Cordery
P J
PJ
Tyrrell
P L
PL
Lantos
M N
MN
Rossor
D000368:Aged; D000544:Alzheimer Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D006801:Humans; D020961:Lewy Body Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D013702:Temporal Lobe / Q000473:pathology; D014055:Tomography, Emission-Computed