Joined: Wed Feb 11, 2009 2:27 pm
New - son of possible DBA patient - symptom comparisons?
My mother, Doris Bishop, will be 77 yrs old on Saturday. My dad passed away last April, 2008. Mom now lives alone in Florida while me and my brother and sister live up in Michigan. Mom is very serious about being independent and living in the warmth of Florida. Also, she does not have found memories of their life in Michigan (lets just say business and politics and lousy friends) Around October, 2008 mom began seeing dad's spirit in their home. She started to become a little paranoid in November that dad was fouling up her car and taking items from the house. In late November she began seeing other (living) family members - a granddaughter, grandson, my brother, my sister, an unknown girlfriend spirit of dad's - and recently, two naked men dancing in the woods near her home. The close relatives were up in Michigan, but mom saw them in the flesh in Florida at her home. In December I set up a mental screening appointment with her general practitioner, Dr. Bassetti, in Sebring, Fla. He suggested that we see a neurologist. I could not return to Florida until this past week. On Feb 11, 2009 mom was screened by a neurologist with a preliminary diagnosis of LBA. She is scheduled to have a brain MRI and EEG tomorrow morning. She is also scheduled to have a PET scan on March 12, 2009. We have an appointment with the neurologist on March 16, 2009 to receive more information - diagnosis and suggested treatment plan. I would like to be prepared for a LBA diagnosis - if it is to be. I am also very interested in comparing mom's current condition to LBA patients to see how many similar symptoms exist.
It is not so bad walking at night through a desert infested with rattlesnakes... as long as you know where they are.
Joined: Fri Aug 11, 2006 1:46 pm
Location: SF Bay Area (Northern CA)
Jean on this Forum lives in Sebring, FL. You might contact her to get the name of the physicians her late husband saw for LBD.
Just to be sure....in your subject you said "DBA" and in your post you said "LBA." I'm assuming you mean LBD - Lewy Body Dementia.
Have you checked out the list of symptoms on lbda.org to see how many of these your mother has? You mentioned hallucinations but said nothing about dementia (which is different than hallucinations), fluctuating cognition or parkinsonism.
Joined: Sat Jan 03, 2009 2:59 pm
Glad you found the forums and I am sorry for your Mother's possible DX of LBD, it will be hard for your mom to remain in FL on her own as time goes on if this is LBD or for that matter most dementia's.
I have a Criteria sheet that I use for the LBDA help-line I will include it here and I often suggest that people copy it , check off what applies to their loved one and take that to the doctor appointment.
DIAGNOSTIC CRITERIA - Central and Core Features for clinical diagnosis
CENTRAL FEATURE OF LBD(must be present for diagnosis of LBD)
- Progressive dementia ? Impairment of *activities of daily living (cognitive impairment) *Activities of Daily Living (ADL) Personal care activities necessary for everyday living such as eating, bathing, grooming, dressing, mobility in home and toileting (continence).
Instrumental ADL - Activities related to independent living and include preparing meals, taking medication, managing money, getting to places beyond walking distance, doing laundry, shopping for groceries or personal items, performing light or heavy housework, and using a telephone.
CORE FEATURES OF LBD (PROBABLE LBD may be diagnosed with the presence of dementia PLUS TWO core features, OR one core feature and one suggestive feature).
- Fluctuating cognition or alertness are periods of time when cognition and arousal are near normal in contrast to other periods of more marked confusion or hypersomnolence. (cognitive impairment or unknown combination of neurochemical alterations and possibly one or more sleep disorders)
- Recurrent complex (well defined) visual hallucinations. Profound distortion in a person's perception of reality, typically accompanied by a powerful sense of reality. (neurophsychiatric feature)
- Parkinsonism (motor dysfunction)
SUGGESTIVE FEATURES OF LBD (Possible LBD may be diagnosed with dementia plus either one core or one suggestive feature)
- Severe sensitivity to neuroleptics (anti-psychotic drugs) occurs in up to 50% of LBD patients. These medications can worsen the Parkinsonism and/or decrease the cognition and/or increase the hallucinations. Neuroleptic Malignancy Syndrome, a life-threatening illness, has been reported in persons with Lewy Body Dementia.
- REM (rapid eye movement) sleep behavior disorder (RBD), (sleep disorder)
CATEGORIZING LBD SYMPTOMS
Five categories of clinical features that may be present in LBD
Motor Dysfunction (Parkinsonism)
Autonomic Nervous System (ANS) dysfunction
1. Cognitive Impairment:
o Executive dysfunction; difficulty understanding complex or multi-step instructions
o Episodes of disorganized speech
o Disoriented about the time or present location
o Bradyphrenia (slowness of mental processes)
o Visuospatial impairment; depth perception and object orientation; directional sense impairment and geographic disorientation (lost while driving, difficulty navigating in shopping center or own homes)
o Verbal blocking; looses train of thought in the middle of a sentence or conversation.
o Short-term memory; decline in ?active? memory (15-30 seconds)
o Misidentification errors involving people; failure to recognize spouse or children
2. Neurophsychiatric Features:
o Hallucinations: visual (sight) auditory (sound), tactile (touch) and olfactory (smell).
Sensory perception experienced in the absence of an external stimulus.
o Systematized delusions; Capgras syndrome (delusions): belief that a known person has been replaced by an identical looking imposter; non-recognition of mirror image
o Illusions; misperception of an external stimulus; (perceiving chairs, lamps, or mailboxes as people or animals)
o Anxiety, depression
o Anger, sadness
o Agitation, aggressive behavior
o Apathy (lack of emotion, motivation, or enthusiasm)
3. Motor Dysfunction (Parkinsonism):
o Tremors (often postural and symmetric, resting tremor less common)
o Rigidity (stiffness of the limbs and trunk; resistance to movement)
o Facial impassivity
o Bradykinesia (slowing down and loss of spontaneous and automatic movement; ability to start and continue movements)
o Shuffling gait; Stooped posture
o Repeated falls from postural instability or impaired balance and coordination
o Difficulty with fine motor skills (tying shoes and buttoning)
o Dysphagia (swallowing difficulties)
4. Sleep Disorders:
o REM (rapid eye movement) sleep behavior disorder (RBD), including acting out dreams, yelling, flailing limbs, nighttime insomnia, daytime drowsiness
o Restless Leg Syndrome (RLS)
o Excessive daytime somnolence (EDS) (an inability to stay awake when sedentary)
5. Autonomic Nervous System (ANS) dysfunction:
o Orthostatic hypotension, (low blood pressure upon standing) dizziness, light-headedness
o Transient, unexplained loss of consciousness, syncope (fainting), vertigo, falls
o Weakness, fatigue
o Decreased sweating and heat intolerance
o Urinary dysfunction (frequency, urgency and incontinence)
o Constipation, diarrhea, and impotence
o Coat-hanger pain (head and neck)
o Weak or hoarse voice