title: Amitriptyline and lorazepam improved catatonia and occipital hypoperfusion in a patient with DLB.
abstract: A 76-year-old woman presented with catatonia, refusal to eat due to delusion, and visual hallucination. Single photon emission computed tomography showed remarkable occipital hypoperfusion and frontal hyperperfusion. (123)I metaiodobenzyl guanidine myocardial scintigraphy revealed decreased uptake. She was diagnosed as probable dementia with Lewy bodies (DLB). Intravenous or oral L-dopa had no effect on catatonia. Amitriptyline and lorazepam improved catatonia and visual hallucination. Cerebral blood flow of the frontal and occipital lobes seemed to be normalized. Occipital hypoperfusion is one of the features of DLB. Although the mechanism of perfusion abnormality in DLB remains to be clarified, our case suggested that it might be reversible.
authors.affiliation: Department of Neurology, National Hospital Organization, Shiga Hospital, Japan. maeda-kengo@shiga-hosp.jp
authors.forename: Kengo
authors.initials: K
authors.lastname: Maeda
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Ogawa
mesh_terms: D000368:Aged; D000639:Amitriptyline / Q000627:therapeutic use*; D002389:Catatonia / Q000188:drug therapy*; D002560:Cerebrovascular Circulation / Q000187:drug effects; D005260:Female; D006801:Humans; D020367:Iofetamine; D020961:Lewy Body Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D008140:Lorazepam / Q000627:therapeutic use*; D009778:Occipital Lobe / Q000098:blood supply; D019275:Radiopharmaceuticals; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D019275:Radiopharmaceuticals; D000639:Amitriptyline; D020367:Iofetamine; D008140:Lorazepam