Psychiatr. pro Praxi, 2004; 1: 9-11

Demence s lewyho tělísky, diagnostika, klinický význam, možnosti léčby, kazuistika

MUDr. Jiří Konrád
Psychogeriatrický primariát, Psychiatrická léčebna Havlíčkův Brod

Keywords: demention with Lewy#s Bodies (LBD), Lewy Body Disease (LBD), Parkinson#s Disease, nontypical antipsychotics, classical neuroleptics, cholinesterasis inhibitors.

Published: December 31, 2004  Show citation

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Konrád J. Demence s lewyho tělísky, diagnostika, klinický význam, možnosti léčby, kazuistika. Psychiatr. praxi. 2004;9(1):9-11.

Demence s Lewyho tělísky (DLB) je neurodegenerativní onemocnění na pomezí Parkinsonovy a Alzheimerovy nemoci. Má společné příznaky obou poruch a svoje vlastní specifické příznaky - především zrakové halucinace lidských postav a zvířat a fluktuující úroveň kognice a senzitivitu k neuroleptikům. Prevalence nemoci v pozdním stáří je zřejmě dosti vysoká, většina neuropatologických studií prevalenci odhaduje mezi 10-20 % ze všech demencí. Klinicky se ji daří diagnostikovat podstatně méně často (kolem 4 %). DLB je často zaměněna s demencí u Alzheimerovy nemoci, klinická manifestace je zřejmě často nenápadná. Význam diagnostikování DLB spočívá především v rozhodnutí o léčbě - neuroleptika (antipsychotika) nejsou zpravidla lékem první volby. Jako vhodnější se jeví použití inhibitorů cholinesteráz (ICHE) nebo opatrné podávání nových antipsychotik s nepatrnou potencí k vyvolání parkinsonského syndromu.

Demention with Lewy-s Bodies, Diagnosis, Clinical Meaning, Treatment

Lewy-s Bodies Demention (DLB) is the neurodegenerative disease between Parkinson-s and Alzheimer disease. DLB has got common signs and special signs - mostly hallucination humans and animals, and changing levels of cognition and sensitivity to neuroleptics. The prevalence of DLB si rather high, specialy at the old age about 10-20 % of all type of demention. The clinical diagnosis is just about 4 %.

DLB is often mistaken with Alzheimer Disease, clinical manifestation is not conspicuous. Diagnosis meaning is treatment decision - neuroleptics are not first choice medicine. Cholinesterasis inhibitors is better choice or carefull taking a new antipsychotics with low level potention to make Parkinson syndrome.

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