Found on the Johns Hopkins Caregivers's site:
http://www.intelihealth.com/IH/ihtIH/?t=9030
What are the differences between Parkinsons and other dementia?
March 12, 1999
Ask the Doc: Featured Q&A Nervous System and Stroke Archives
Q: My father was diagnosed with Parkinson's about six years ago. Since
then his mental state has been declining. In the past year, he has begun
to have hallucinations, mostly involving "little people" with no feet
and no mouth. They sit in his chair and lie in his bed, etc. This past
summer he was diagnosed as having Parkinson's with Lewy body dementia.
Can you give me any information on this condition, and anything we can
do to help my father?
Robert Joseph Wityk, M.D., is assistant professor of Neurology and
Medicine and director of the Clinical Stroke Service at the Johns
Hopkins Medical Institutions. He is also chairman of the Stroke
Initiative Task Force of the Maryland Affiliate of the
American Heart Association.
A: Parkinson's disease is a degenerative disease of the nervous system
which involves a very small region of the brain called the substantia
nigra. This area is part of a complex group of circuits in the brain
which are involved in movement, and in particular movements we generally
are not conscious of -- such as posture, balance, the degree of
stiffness or flexibility needed in a limb. With loss of cells in the
substantia nigra, a key neurotransmitter -- dopamine -- becomes
deficient, and patients develop problems with stiffness, decreased
movements, tremor, falling and decreased facial expression.
There are other degenerative conditions which also produce symptoms like
Parkinson's disease and are called "Parkinson's - plus" syndromes. These
patients may look like they have Parkinson's initially but later develop
other problems indicating
degeneration in other parts of the nervous system. Lewy body dementia is
a relatively recently described disorder in which there is Parkinson's
disease as well as a particular type of dementia.
Patients often have confused episodes, hallucinations, memory loss and
sometimes sleep disorders or seizures. In Parkinson's disease, the cells
in the substantia nigra have abnormal accumulations of material called
"Lewy bodies," which is a characteristic finding under the microscope.
In Lewy body dementia, these same abnormalities are seen in cells in the
grey matter of the brain.
The cause of the condition remains unknown, and there is no treatment to
reverse or cure this condition. Patients may respond to some degree to
conventional Parkinson's medications (e.g., tranquilizers or even some
over-the-counter medications such as
Benadryl), which may precipitate confusion or hallucinations. Patients
who become very agitated or combative may require antipsychotic
medications, although these must be used cautiously, because they can
worsen the motor problems.
If you would like additional information, there are several associations
you might want to contact:
The American Parkinson Disease Association, Inc. (1-800-223-2732)
The National Parkinson Foundation, Inc. (1-800-327-4545)
The Parkinson Disease Foundation (1-800-457-6676)
United Parkinson Foundation (1-312-733-1893)
November 20, 1998
Copyright The Johns Hopkins University, 1996-1998. All rights reserved.
--
Judith Richards, London, Ontario, Canada
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