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Demência com corpos de Lewy

Последний просмотренный: 19 Jun 2025
Last updated: 20 Jun 2023

Резюме

Определение

Анамнез и осмотр

Ключевые диагностические факторы

  • presença de fatores de risco
  • flutuações
  • alucinações visuais
  • Sintomas motores
  • distúrbio comportamental do sono de movimento rápido dos olhos (REM)
Полная информация

Другие диагностические факторы

  • grave sensibilidade ao antipsicótico
  • depressão
  • ansiedade
  • quedas repetidas e síncope
  • hipotensão ortostática
  • sintomas urinários
  • constipação
  • anormalidades da atenção e do processamento visual
  • delírios
  • Hipersonia
  • hiposmia
  • alucinações auditivas
Полная информация

Факторы риска

  • idade avançada
  • ocorrência familiar
Полная информация

Диагностические исследования

Исследования, которые показаны в первую очередь

  • hormônio estimulante da tireoide (TSH) sérico
  • vitamina B12 sérica
  • tomografia computadorizada (TC) do crânio
  • ressonância nuclear magnética (RNM) de crânio
Полная информация

Исследования, проведение которых нужно рассмотреть

  • Hemograma completo
  • perfil metabólico
  • folato sérico
  • teste sérico do VDRL (Venereal Disease Research Laboratory, laboratório de pesquisa de doenças venéreas)
  • exame de urina para detecção de drogas
  • urinálise
  • teste de vírus da imunodeficiência humana (HIV)
  • TC por emissão de fóton único (SPECT)/tomografia por emissão de pósitrons (PET)
  • EEG quantitativo
  • polissonografia
  • Análise do líquido cefalorraquidiano (LCR)
  • exame neuropsicológico
  • cintilografia miocárdica com metaiodobenzilguanidina (MIBG)
Полная информация

Алгоритм лечения

ПРОДОЛЖЕНИЕ

todos os pacientes

Составители

Авторы

Alan J. Lerner, MD

Professor of Neurology

Department of Neurology

University Hospitals Cleveland Medical Center

Case Western Reserve University

Cleveland

OH

Раскрытие информации

AJL declares that he has no competing interests.

Mohamed I. Elkasaby, MD

Fellow in Behavioral Neurology and Neuropsychiatry

Department of Neurology

University Hospitals Cleveland Medical Center

Case Western Reserve University

Cleveland

OH

Раскрытие информации

MIE declares that he has no competing interests.

Выражение благодарностей

Dr Alan J. Lerner and Dr Mohamed I. Elkasaby would like to gratefully acknowledge Dr Brian S. Appleby, Dr Ethan Gore, Dr Rajeet Shrestha, Dr Timothy Wuerz, Dr Julie Schneider, Dr Viola Fahmy, and Dr Sube Banerjee, previous contributors to this topic.

Раскрытие информации

BSA, EG, RS, TW, JS, VF, and SB declare that they have no competing interests.

Рецензенты

Bryan Bernard, PhD

Assistant Professor and Clinical Neuropsychologist

Department of Neurological Sciences

Rush University Medical Center

Chicago

IL

Раскрытие информации

BB declares that he has no competing interests.

James E. Galvin, MD, MPH

Associate Professor

Neurology, Psychiatry and Neurobiology

Director

Memory Diagnostic Center and Alzheimer Treatment Unit

Director

Education and Community Outreach

Alzheimer Disease Research Center

Washington University School of Medicine

St Louis

MO

Раскрытие информации

JEG declares that he has no competing interests.

Ian McKeith, MBBS

Professor of Old Age Psychiatry

Clinical Director

Institute for Ageing and Health

Newcastle University

Newcastle

UK

Раскрытие информации

IM is the author of several references cited in this topic.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

McKeith IG, Boeve BF, Dickson DW, et al. Diagnosis and management of dementia with Lewy bodies: fourth consensus report of the DLB Consortium. Neurology. 2017 Jul 4;89(1):88-100.Полный текст  Аннотация

Expert Panel on Neurological Imaging; Moonis G, Subramaniam RM, Trofimova A, et al. ACR Appropriateness Criteria® dementia. J Am Coll Radiol. 2020 May;17(5s):S100-12.Полный текст  Аннотация

Taylor JP, McKeith IG, Burn DJ, et al. New evidence on the management of Lewy body dementia. Lancet Neurol. 2020 Feb;19(2):157-69.Полный текст  Аннотация

O'Brien JT, Holmes C, Jones M, et al. Clinical practice with anti-dementia drugs: a revised (third) consensus statement from the British Association for Psychopharmacology. J Psychopharmacol. 2017 Feb;31(2):147-68. Аннотация

Rolinski M, Fox C, Maidment I, et al. Cholinesterase inhibitors for dementia with Lewy bodies, Parkinson's disease dementia and cognitive impairment in Parkinson's disease. Cochrane Database Syst Rev. 2012 Mar 14;(3):CD006504.Полный текст  Аннотация

Reus VI, Fochtmann LJ, Eyler AE, et al. The American Psychiatric Association practice guideline on the use of antipsychotics to treat agitation or psychosis in patients with dementia. Am J Psychiatry. 2016 May 1;173(5):543-6.Полный текст  Аннотация

Статьи, указанные как источники

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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