Maclean L E, Collins C C, Byrne E J
Princess Margaret Hospital, Christchurch, New Zealand.
Int Psychogeriatr. 2001 Sep;13(3):277-88. doi: 10.1017/s1041610201007670.
Dementia with Lewy bodies (DLB) is a common cause of the dementia syndrome. Symptomatic treatment of the fluctuating cognition, visual hallucinations, and sleep disturbance that characterize this condition is challenging; neuroleptics are relatively contraindicated. We describe eight patients fulfilling the consensus diagnostic criteria for probable DLB who were treated with rivastigmine. Clinical features rated were: cognition by the Modified Mini-Mental State Examination (3MS); and behavioral and psychiatric symptoms by the Neuropsychiatric Inventory (NPI). Additional information was obtained from family and nursing reports. Seven patients showed resolution or improvement in cognition and neuropsychiatric symptoms as demonstrated by improvement in their 3MS and NPI scores. They also became more independent in mobility and activities of daily living, and the majority returned to live in their own home. Of the seven patients with sleep disruption, six improved. One case had no improvement in his symptomatology and the rivastigmine was stopped. Outcomes in this case series suggest that rivastigmine is well tolerated in clinical practice.
路易体痴呆（DLB）是痴呆综合征的常见病因。对这种疾病所特有的认知波动、视幻觉和睡眠障碍进行对症治疗具有挑战性；抗精神病药物相对禁忌使用。我们描述了8例符合可能的DLB共识诊断标准并接受卡巴拉汀治疗的患者。评估的临床特征包括：通过改良简易精神状态检查表（3MS）评估认知；通过神经精神科问卷（NPI）评估行为和精神症状。还从患者家属和护理报告中获取了其他信息。7例患者的认知和神经精神症状得到缓解或改善，3MS和NPI评分的改善证明了这一点。他们在行动能力和日常生活活动方面也变得更加独立，大多数人回到自己家中生活。7例有睡眠障碍的患者中，6例有所改善。有1例患者的症状没有改善，卡巴拉汀停药。该病例系列的结果表明，卡巴拉汀在临床实践中耐受性良好。
