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PSYCH up2date 2013; 7(06): 337-348
DOI: 10.1055/s-0033-1349667
Organische psychische Störungen
© Georg Thieme Verlag KG Stuttgart · New York

Demenz mit Lewy-Körpern

Matthias W. Riepe
,
Claudia Lanza
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Publication Date:
07 November 2013 (online)

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Kernaussagen

Die Assoziation eines demenziellen Syndroms und einer parkinsonoiden extrapyramidalmotorischen Symptomatik ist häufig. Allgemein etablierte Konsensuskriterien erlauben die Diagnose einer Lewy-Körper-Demenz – allerdings schließt diese auf klinischen Kriterien basierende Diagnose auch die Diagnose einer Demenz anderer Ätiologie nicht aus. Im klinischen Alltag treten häufig Mischformen mit begleitender Alzheimer-Erkrankung oder vaskulärer Enzephalopathie auf.

Klinisch bedeutsam ist die Vorsicht bei der Anwendung neuroleptischer Substanzen bei älteren Personen mit demenzieller Symptomatik. Symptome, die im Erwachsenenalter gut auf eine neuroleptische Behandlung ansprechen, z. B. Wahn oder Halluzinationen, sind bei Patienten mit kognitiven Einschränkungen nur mit Vorsicht anzuwenden, da zumindest begleitend eine Neuroleptika-Empfindlichkeit in Assoziation zum Vorliegen von Lewy-Körpern bestehen kann. Außer in Notfallsituationen sollte daher bevorzugt auch bei diesen Patienten zunächst mit einer cholinergen Medikation begonnen werden.

 

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