Table of Contents
Washington University Experience | NEURODEGENERATION | Lewy Body Disease (LBD) | 2 LBD - Gross Pathology - Cerebrum LBD -Dementia | 9A0 Case 9 History
Case 9 History ---- This 84-year-old female was first seen in the Movement Disorders Center at age 82. She had begun to have tremor of the hands at age 67 (L>R). Soon after that, she developed slower gait and freezing. By age 68 or 69, handwriting became smaller. At age 72, she also developed trouble with concentration and memory and became disoriented. At age 75, gait became much slower and balance became impaired. She needed assistance to stand and walk and had become more stooped. By age 82 she could no longer use a remote control and lost items around the house.She required assistance with all activities of daily living. Initially, ropinirole and selegiline provided some symptomatic relief. Subsequently, she switched to levodopa and pramipexole which markedly reduced tremor. She developed dyskinesias and wearing off with some foot dystonia. She also had mild orthostasis but no syncope. She had urinary urgency and incontinence. She did not have hallucinations, except when taking ropinirole but none after that was stopped. In the last 2 years of her life, she did have excessive daytime sleepiness. One month prior to death, she had the sudden onset of reduced responsiveness, increased weakness and had a right parietal infarct with substantial swelling from which she never recovered. She was placed in hospice and subsequently died at age 84 from inanition and dehydration with appropriate sedation and comfort measures.
