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 Treating Catatonia and Occipital Hypoperfusion in DLB 
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Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)
Post Treating Catatonia and Occipital Hypoperfusion in DLB
This is the abstract of a Japanese case report on a woman with probable DLB, based on a SPECT and myocardial scintigraphy. She was catatonic and refused to eat due to a delusion and visual hallucination. The catatonia and visual hallucination were resolved through an antidepressant (amitryptyline; brand name is Elavil) and a muscle relaxant (lorazepam; brand name is Ativan). It seems that the authors are saying that the catatonia was caused by the occipital hypoperfusion of DLB and this hypoperfusion was reversed through medication.
Robin


Internal Medicine. 2011;50(4):363-6. Epub 2011 Feb 15.

Amitriptyline and Lorazepam Improved Catatonia and Occipital Hypoperfusion in a Patient with DLB.

Maeda K, Ogawa N.
Department of Neurology, National Hospital Organization, Shiga Hospital, Japan.

Abstract
A 76-year-old woman presented with catatonia, refusal to eat due to delusion, and visual hallucination. Single photon emission computed tomography showed remarkable occipital hypoperfusion and frontal hyperperfusion. (123)I metaiodobenzyl guanidine myocardial scintigraphy revealed decreased uptake. She was diagnosed as probable dementia with Lewy bodies (DLB). Intravenous or oral L-dopa had no effect on catatonia. Amitriptyline and lorazepam improved catatonia and visual hallucination. Cerebral blood flow of the frontal and occipital lobes seemed to be normalized. Occipital hypoperfusion is one of the features of DLB. Although the mechanism of perfusion abnormality in DLB remains to be clarified, our case suggested that it might be reversible.

PubMed ID#: 2132577 (see pubmed.gov for this abstract only)


Fri Feb 18, 2011 2:40 pm
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Joined: Fri Dec 31, 2010 3:07 pm
Posts: 1039
Location: Minnesota
Post Re: Treating Catatonia and Occipital Hypoperfusion in DLB
Sounds good! I hope that this case study inspires lots of folowup research.

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Jeanne, 68 cared for husband Coy, 86. RBD for 30+ years; LDB since 2003, Coy at home, in early stage, until death in 2012


Fri Feb 18, 2011 3:13 pm
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3213
Location: WA
Post Re: Treating Catatonia and Occipital Hypoperfusion in DLB
Maybe if we stand them on their heads for a few minutes a day it would help! :P

I believe lorazepam is an antianxiety agent, not a muscle relaxant.

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Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Fri Feb 18, 2011 3:36 pm
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Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)
Post Re: Treating Catatonia and Occipital Hypoperfusion in DLB
It's both.


Fri Feb 18, 2011 5:30 pm
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Joined: Wed Oct 28, 2009 11:53 am
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Location: Ocala, FL
Post Re: Treating Catatonia and Occipital Hypoperfusion in DLB
The online material I read about Ativan says it often causes falls in the elderly.

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Leone Carroll (75); wife of Dale (75) who passed away March 23, 2011


Fri Feb 18, 2011 6:16 pm
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Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)
Post Re: Treating Catatonia and Occipital Hypoperfusion in DLB
That's because it's sedating.

In this case, the woman was catatonia so fall prevention was not top of the mind.


Fri Feb 18, 2011 7:47 pm
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Joined: Fri Dec 31, 2010 3:07 pm
Posts: 1039
Location: Minnesota
Post Re: Treating Catatonia and Occipital Hypoperfusion in DLB
:lol: :lol: You don't worry about falling risks for catotonic persons?

I'm always puzzled by people who worry that a drug may be habit-forming, when the patient is 91 and unable to function without it. The problem with developing this habit is ... ??

Carefully considering the risks and side effects of drugs is important, but, gee, I think context counts. At 65 I think I don't have to worry about drugs that are potentially harmful to unborn children, right? :lol: :lol:

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Jeanne, 68 cared for husband Coy, 86. RBD for 30+ years; LDB since 2003, Coy at home, in early stage, until death in 2012


Fri Feb 18, 2011 8:14 pm
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Joined: Wed Oct 28, 2009 11:53 am
Posts: 969
Location: Ocala, FL
Post Re: Treating Catatonia and Occipital Hypoperfusion in DLB
Yes, like cutting down on candy .... when you are dying. :lol: I figure Dale should be allowed to enjoy whatever......

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Leone Carroll (75); wife of Dale (75) who passed away March 23, 2011


Fri Feb 18, 2011 10:09 pm
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