A case study in the treatment of dementia with Lewy bodies.
OBJECTIVE
To describe the assessment and treatment of an elderly woman with parkinsonism, progressive memory and cognitive deficits, and visual hallucinations.


METHODS
The patient presented with a 10-year history of hand tremors, an 8-year history of short-term memory problems, and a 3-4-year history of visual hallucinations. Treatment with donepezil and rivastigmine (successively) did not produce the desired benefits. Then she was started on galantamine 4 mg b.i.d. (escalated to 8 mg b.i.d.).


RESULTS
The patient's social interaction improved and cognitive decline appeared to be stabilized; hallucinations and agitation were also better controlled.


CONCLUSIONS
By current criteria, this subject would be labeled as having Parkinson's disease with dementia, although she exhibited the core features of dementia with Lewy body disease. As suggested in previous studies, cholinesterase inhibitors may be effective in treating psychotic symptoms; however, all currently available agents may not be equally effective.
Kaufer
Daniel I
DI
Department of Neurology, UNC School of Medicine, Chapel Hill, NC 27599, USA. kauferd@glial.med.unc.edu
D000368:Aged; D000369:Aged, 80 and over; D002219:Carbamates / Q000627:therapeutic use; D003072:Cognition Disorders / Q000188:drug therapy / Q000209:etiology*; D000077265:Donepezil; D004351:Drug Resistance; D005260:Female; D005702:Galantamine / Q000627:therapeutic use*; D006212:Hallucinations / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D007189:Indans / Q000627:therapeutic use; D020961:Lewy Body Disease / Q000150:complications / Q000188:drug therapy* / Q000523:psychology*; D018696:Neuroprotective Agents / Q000627:therapeutic use; D018697:Nootropic Agents / Q000627:therapeutic use*; D048448:Phenylcarbamates; D010880:Piperidines / Q000627:therapeutic use; D011595:Psychomotor Agitation; D000068836:Rivastigmine; D012919:Social Behavior
D002219:Carbamates; D007189:Indans; D018696:Neuroprotective Agents; D018697:Nootropic Agents; D048448:Phenylcarbamates; D010880:Piperidines; D005702:Galantamine; D000077265:Donepezil; D000068836:Rivastigmine