ADIGRAT UNIVERSITY

college of medicine and health science

Department of psychiatry nursing
Group assignment

1 April 14, 2019

 Con…
 Presented by group 5 and 6
Name Id no
1.Girmaw yideg 02187/09
2.Abriham Negriew 02052/09
3.Hana Tsegaye 02205/09
4.G/hawaria G/silasie 02155/09
5.Mohamed eshetu 02263/09
6.Lilina samson 02231/09
7.Yasine kasie 02354/09
8.Milion halefom 02254/09
2 April 14, 2019
 outline
 Lewy Body Disease
 Huntington’s disease (HD)
 Clinical features
 management

3 April 14, 2019

 objectives
 After completing this session we able to
 define lewy body dementia and Huntington’s Disease
 Management of lewy body dementia and Huntington’s
Disease
 Know the clinical features

4 April 14, 2019

 Lewy Body Disease
 Lewy body disease is a dementia clinically similar to
Alzheimer’s disease
 characterized by ;
 Hallucinations
 parkinsonian features and
 extrapyramidal signs

5 April 14, 2019

 Con…
 Lewy inclusion bodies are found in the cerebral cortex
 The exact incidence is unknown
Epidemiology
 Age of onset: 50–83yrs.
 Age at death: 68–92yrs.

6 April 14, 2019

 Clinical features
 Parkinsonism (70%: bradykinesia, limb rigidity, gait
disorder)
 fluctuating cognitive performance and level of consciousness
 complex hallucinations
 recurrent falls
 syncope {30%: due to autonomic dysfunction}

7 April 14, 2019

 Pathological features
 neuronal inclusions of abnormally phosphorylated
neurofilament proteins aggregated with ubiquitin and A-
synuclein found in brainstem nuclei
 basal ganglia
 paralimbic and
 neocortical structures.

8 April 14, 2019

 Con…
 Associated with neuronal loss
Management
 AChEIs Not yet recommended by National Guidelines
 substantial provisional evidence suggests AChEIs effective in
some DLB cases
 Increase cognitive function
 decrease apathy/psychosis/agitation

9 April 14, 2019

 Con…
 Clonazepam may be useful for
 sleep disturbance (vivid dreams,
 muscle atonia,
 excessive jerking and
 other complex movements
 Anti-Parkinsonism medication
 use cautiously for clinically significant motor symptoms
because of risk of exacerbating psychotic symptoms

10 April 14, 2019

 Huntington’s Disease
 Huntington’s disease is classically associated with the
development of dementia.
 the subcritical type of dementia characterized by
 more motor abnormalities and
 fewer language abnormalities than in the cortical type of
dementia

11 April 14, 2019

 Con…
 The dementia of Huntington’s disease exhibits
 psychomotor slowing and
 difficulty with complex tasks
 but memory, language, and insight remain relatively intact in
the early and middle stages of the illness.

12 April 14, 2019

 Pathology
 Decreased GABA neurons in the basal ganglia
 this leads to increased
 stimulation of the thalamus and cortex by the globus pallidus.
 increase in DA transmission

13 April 14, 2019

 Clinical features
 Chorea movement characterized by
 initial jerks
 tics
 gross involuntary movements of all parts of the body
 increased tone with rigidity and stiffness
 abnormal eye movements.

14 April 14, 2019

 Con…
• Anxiety and depression are common
• Psychosis occurs early and paranoia is common—
‘schizophrenia-like’
• Aggression and violence
• Subcritical dementia—slowing, apathy, and amnesia

15 April 14, 2019

 Treatment
 No treatment arrests the course of the disease
However haloperidol (or other antipsychotics) may help
reduce abnormal movements.

16 April 14, 2019

 Con…

17 April 14, 2019