This is the 2nd Lewy Body post.  Thanks to Bob Howard for the info.


>Date: Sat, 28 Mar 1998 22:43:00 -0600
>From: "Robert B. Howard" <[log in to unmask]>
>Subject: Lewy Body Disease
>Sender: "Caregivers Are Really Essential (CARE)" <[log in to unmask]>
>To: Multiple recipients of list CARE <[log in to unmask]>
>Reply-to: "Caregivers Are Really Essential (CARE)"
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>Sender:       "Caregivers Are Really Essential (CARE)"
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>Poster:       "Robert B. Howard" <[log in to unmask]>
>Subject:      Lewy Body Disease
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>
>While I was absent from the CARE net for 6 weeks, I picked up my messages
>at my son's place on one occasion and found a request for information re
>Lewy Body Disease. I could not provide this from that site because I did
>not have the material there. I tried to send the request back to my home
>site but failed. I do not recall who it was that requested the info. At the
>risk of providing all of you with material you do not want, I am sending
>the following:
>
>I have been reviewing the literature re Diffuse Lewy Body Disease (DLBD),
>about which a good bit has been written in the past few year. It is stated
>that Lewy Bodies, which are distinct from the "tangles" of Alzheimer's
>Disease, are the second most frequent pathological finding in patients with
>dementia. There is some lack of clarity whether neurologists consider DLBD
>a separate entity with some features of PD or a variant of/late development
>in PD. In any event, it does seem that Lewy Bodies are associated with
>dementia. This is described as often rapidly progressive, characterized by
>attentional impairments, disproportionate problem solving and visiospatial
>difficulties, fluctuation in cognitive function, and well-formed visual
>hallucinations, along with symptoms of (or similar to those) of PD except
>for lower frequency and mild degree of tremor. Essentially all of the
>characteristics applied to my wife.
>
>The diagnosis of Alzheimer's Disease can be difficult in the presence of
>PD. Both are relatively common, so they can coexist. But is also true that
>about 30% of PD patients get mental changes later in the course. Such was
>the case with my late wife.
>
>There are said to be subtle differences in the dementia of PD and AD.
>Fluctuations with clear periods alternating with periods of confusion have
>been reported more frequently with PD, as have well organized
>hallucinations, often of bugs or small people. The dementia of PD is
>somewhat more likely to occur in patients who have had "central" PD, i.e.,
>gait and speech disturbances in contrast to severe tremors of the
>extremities.
>
>I'm not sure how important the differentiation is from the clinical
>standpoint. Patients with PD dementia apparently do not do well on Mirapex.
>
>One postulate that seems reasonable is that the Lewy Body pathology is
>characteristic of PD when it occurs in the substantia nigra (the place
>where dopamine is made.) When it "spreads" to other parts of the brain,
>dementia may occur. According to this postulate Lewy Body pathology may
>start in other segments of the brain, and then dementia may occur early,
>with parkinsonian symptoms coming later.
>
>I hope that this will be of interest to some of you.
>
>Bob Howard
>
>
>
>Bob Howard, occasionally
>known formally as
>Robert B. Howard
>1312 Wisconsin St. #104
>Hudson, WI, 54016
>715.386.3596
>e-mail <[log in to unmask]>
>CG for 12 years for Lorraine,
>who died 9/17/97
>