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Demens med Lewy-legemer

Sist revidert:
Sist revidert av:


Definisjon:
Kronisk progredierende nevrodegenerativ sykdom som er karakterisert ved redusert og fluktuerende kognitiv funksjon, tilbakevendende synshallusinasjoner, parkinsonistiske trekk, overfølsomhet for antipsykotika 
Forekomst:
Tilstanden utgjør trolig ca. 10-15% av alle demenstilfeller i Norge
Symptomer:
Ligner ofte på delir med fluktuerende konfusjon, oppmerksomhetsproblemer, psykiatriske symptomer og kognitiv svekkelse
Funn:
Ofte visuospatiale og eksekutive vanskeligheter ved nevropsykologiske undersøkelser. Vanligvis ett eller flere parkinsonistiske symptomer. Kognitiv svikt, men MMSE er lite sensitiv i tidlig fase 
Diagnostikk:
Andre relevante undersøkelser er først og fremst MR eller CT av hjernen
Behandling:
Organisering av støttetiltak er hovedbehandlingen, men kolinesterasehemmere kan ha effekt
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  • McKeith IG, Boeve BF, Dickson DW, et al. Diagnosis and management of dementia with Lewy bodies: Fourth consensus report of the DLB Consortium. Neurology 2017; 4;89(1): 88-100. pmid:28592453
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  • Peter D. Jost, spesialist allmennmedisin, redaktør NEL

Tidligere fagmedarbeidere

  • Ivar B. Mediås, spesialist i allmennmedisin, leder for NSAM referansegruppe i geriatri, Sørum legesenter, Sørumsand
  • Bjørnar Grenne, PhD, konst. overlege, Klinikk for hjertemedisin, St. Olavs Hospital, Trondheim