Dementia with Lewy bodies
Dementia with Lewy bodies
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DOI：
10.1192/bjp.180.2.144
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发表时间：
2002-02-01
影响因子：
10.5
通讯作者：
McKeith, IG
中科院分区：
文献类型：
--
作者：
McKeith, IG
路易体痴呆（DLB）是一种常见的痴呆亚型，在过去的十年中才被认识到，并且仍然广泛未被诊断。目的综述DLB的病理和临床特点，探讨其诊断方法，并提出安全有效的治疗策略。方法对重点文献进行选择性复习。结果使用可操作的标准，DLB的临床诊断准确度与阿尔茨海默病或帕金森病相似，检测不足主要是由于认知波动标准定义不清。辅助检查，特别是神经影像学检查，可以帮助鉴别诊断。建议慎用抗精神病药物。胆碱酯酶抑制剂可能对DLB特别有效。结论：临床医生应该意识到DLB是路易体疾病谱系的一部分。抗精神病药敏感性反应和对胆碱能治疗的良好反应是治疗的重要方面。利益声明无。
Background Dementia with Lewy bodies (DLB) is a common dementia subtype that has only been recognised in the past decade and that remains widely underdiagnosed.Aims To review the pathological and clinical features of DLB, to consider methods of investigation and diagnosis, and to recommend safe and effective management strategies.Method A selective review was made of the key literature. Results Using operationalised criteria, DLB can be clinically diagnosed with an accuracy similar to that achieved for Alzheimer's disease or Parkinson's disease Underdetection is largely due to poor definition of the criterion of cognitive fluctuation. Ancillary investigations, particularly neuroimaging, can aid in differential diagnosis. Extreme caution in the use of neuroleptic medication is advised. Cholinesterase inhibitors may be particularly effective in DLB.Conclusions Clinicians should be aware of DLB as part of a spectrum of Lewy body disorders. Neuroleptic sensitivity reactions and good response to cholinergic therapies are important aspects of management.Declaration of interest None.