RESUMEN
INTRODUCTION: Lewy body dementia (DLB) is common but frequently misdiagnosed as Alzheimer's disease plus delirium or parkinsonism. DRUGS USED IN THIS DISORDER CAN CAUSE EXACERBATIONS: neuroleptic medication is relatively contraindicated because some patients show severe neuroleptic sensitivity, antiparkinsonian medication has the potential to exacerbate psychotic symptoms, and even cholinesterase inhibitors, while relatively safe, have provoked adverse responses in some DLB patients. There are few data available about the use of memantine in DLB. CASE PRESENTATION: A 74-year-old man was diagnosed with Alzheimer disease and parkinsonism. After memantine was started he developed severe fluctuations in awareness, visual hallucinations, agitation, and worsened parkinsonism. When he was evaluated thoroughly, the diagnosis was revised to Lewy body dementia, leading to changes in treatment that were associated with dramatic improvement in the patient's mental status. CONCLUSIONS: In our patient, motor and cognitive symptoms worsened with memantine treatment; these resolved after memantine was discontinued.
Asunto(s)
Agonistas de Dopamina/efectos adversos , Enfermedad por Cuerpos de Lewy/inducido químicamente , Memantina/efectos adversos , Anciano , Enfermedad de Alzheimer/tratamiento farmacológico , Agonistas de Dopamina/administración & dosificación , Alucinaciones/inducido químicamente , Humanos , Masculino , Memantina/administración & dosificación , Enfermedad de Parkinson Secundaria/inducido químicamenteRESUMEN
Se investigó la prevalencia de la demencia sobre la población de mayores de 80 años en el municipio de Oviedo, España, por medio de un estudio de dos fases. Durante la primera fase usamos el CAMCOG (examen cognitivo incluido en la entrevista CAMDEX) como instrumento de screening. Durante la segunda fase, fue realizada una evaluación clínica detallada para el diagnóstico o no diagnóstico de demencia de acuerdo con los criterios diagnósticos DSM-III-R. Con la muestra seleccionada de la población (n=201), manejamos para evaluar 76 personas. La prevalencia total de demencia obtenida fue 19.7%. La prevalencia de enfermedad de Alzheimer y demencia vascular fueron de 15.8% y 2.6% respectivamente. Fue observada una relación significativa entre el desarrollo de enfermedad de Alzheimer y antecedentes de demencia en parientes de primer grado. Nuestras cifras de prevalencia de demencia son similares a otros estudios europeos publicados (AU)
We have investigated the prevalence of dementia among the over 80 population of age in the city of Oviedo, Spain, by means of a two-stage study. During the first stage we have used CAMCOG (cognitive examination included in the CAMDEX interview) as a screening instrument. During the second stage, a detailed clinical evaluation has been carried out in order to confirm or not the dementia diagnosis according to the DSM-III-R criteria. Out the selected population (n=201), we have managed to evaluate 76 people. The global prevalence of dementia obtained was 19.7%. The prevalence of Alzheimers disease and vascular dementia were 15.8% and 2.6% respectively. A statistically significant correlation between developing Alzheimers disease and the precedents of dementia among frist-degree realtives has been observed. Our figures of the prevalence of dementia are similar to those reported in other European studies (AU)