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Washington University Experience | NEURODEGENERATION | Lewy Body Disease (LBD) | 4 LBD - Gross Pathology - LBD-Dementia with AD | 6A0 Case 6 History
Case 6 History ---- This 94yo male has a history of coronary artery disease, colon cancer, peptic ulcer disease and at least a six year history of Parkinsonian symptoms. Difficulty rising from a chair developed in 1994, followed several years later by tremor in the right hand and jaw, akinesia, stooped posture. Dementia was prominent and he was unable to perform activities of daily living independently for at least the past four years. His Parkinsonian symptoms were progressive with only modest response to Sinemet. He also had evidence of peripheral neuropathy on exam in 1998. The clinical differential diagnosis included Parkinson's disease with Alzheimer's disease, diffuse Lewy body disease, or striato-nigral degeneration. Approximately one week prior to death he had the appearance of feces in his urine that was presumed secondary to a spontaneous colonic-urinary fistula. The family declined surgical intervention, comfort care was initiated, and he died at home of presumed urosepsis.
