Chapter

Dementia with Lewy bodies

I. G. McKeith

in New Oxford Textbook of Psychiatry

Second edition

Published on behalf of Oxford University Press

Published in print February 2012 | ISBN: 9780199696758
Published online October 2012 | e-ISBN: 9780191743221 | DOI: http://dx.doi.org/10.1093/med/9780199696758.003.0045
Dementia with Lewy bodies

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Lewy bodies are spherical neuronal inclusions, first described by the German neuropathologist Friederich Lewy while working in Alzheimer's laboratory in Munich in 1912. In 1961, Okazaki published case reports about two elderly men who presented with dementia and died shortly after with severe extrapyramidal rigidity. Autopsy showed Lewy bodies in their cerebral cortex. Over the next 20 years, 34 similar cases were reported, all by Japanese workers. Lewy body disease was thus considered to be a rare cause of dementia, until a series of studies in Europe and North America, in the late 1980s, identified Lewy bodies in the brains of between 15 and 20 per cent of elderly demented cases reaching autopsy. Dementia with Lewy bodies (DLB) is unlikely to be a newly occurring disorder, since re-examination of autopsy material collected from elderly demented patients in Newcastle during the 1960s, reveals cortical Lewy bodies in 17 per cent of cases. The recent recognition of DLB as the second most common form of degenerative dementia in old age is largely due to the widespread use of improved neuropathological techniques, initially antiubiquitin immunocytochemistry, and more recently specific staining for alpha-synuclein which is a core constituent of Lewy bodies and related lesions.

Chapter.  6590 words.  Illustrated.

Subjects: Psychiatry ; Neurology

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