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Washington University Experience | NEURODEGENERATION | Lewy Body Disease (LBD) | 4 LBD - Gross Pathology - LBD-Dementia with AD | 1A0 Case 1 History
Case 1 History ---- This 72yo male was seen at age 66 in May 2006. In 2000, he suffered a cat bite that required IV antibiotics and, soon thereafter, he developed decreased night vision while driving to familiar areas, which progressed to significant blindness in both eyes. He had vivid dreams all his life but not visual or auditory hallucinations, slowness, falls, shuffling, or tremor. Subsequently, psychometric testing revealed temporal and geographic disorientation; errors in spelling world backwards, months, and counting backwards; 2/3 on delayed recall; 0/5 John Brown phrase; and logical memory 1. MRI brain in 2003 which revealed mild atrophy and a PET scan in 2005 which reported bilateral parietal-occipital decrease in metabolism consistent with Alzheimer’s disease (AD). The clinician rated him CDR 0.5, atypical dementia of the Alzheimer’s type (DAT), diffuse Lewy body dementia (DLBD), or toxic, infectious, or vitamin deficiency cause from 2000. The clinician rated him CDR 2, posterior variant AD. He was admitted to a nursing home in 2010. In February 2011, he developed a high fever, decreased oxygen saturations, and was on antibiotics. He expired in September 2012 at age 72 due to bowel obstruction, upper GI bleed, and hematuria. He endorsed her was unable to recognize family, had temporal and geographic disorientation, severely impaired judgment and problem solving, no engagement with other residents, no meaningful activities, and severely impaired ADLs. The nurse conducting the postmortem interview rated him CDR 3.
