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Dementia with Lewy bodies presenting as probable epileptic seizure

Mya Z Tun1, Wee Kheng Soo2,3, Kevin Wu3

  • 1Geriatric Medicine, Monash Health, Victoria, Australia.

BMJ Case Reports
|September 29, 2017
PubMed

Insights

An 83-year-old man experienced altered consciousness, likely seizures, amidst cognitive decline. Advanced imaging supported a diagnosis of dementia with Lewy bodies (DLB), highlighting the need to consider comorbidities in elderly patients.

Area of Science:

  • Neurology
  • Geriatrics
  • Neuroimaging

Background:

  • Cognitive decline is common in the elderly, often presenting with acute changes in consciousness.
  • Differential diagnoses for altered consciousness in older adults typically include stroke and seizures.

Observation:

  • An 83-year-old male presented with recurrent episodes of altered consciousness and acute confusion, superimposed on a 6-year history of cognitive decline.
  • Initial investigations, including CT, MRI, and EEG, were negative for cerebrovascular accidents, epileptogenic foci, or epileptiform activity.

Findings:

  • A probable diagnosis of seizure in the context of dementia with Lewy bodies (DLB) was established.
  • Brain SPECT and FDG-PET imaging supported the diagnosis of DLB, indicating underlying neurodegenerative changes.

Implications:

  • This case underscores the importance of considering less common etiologies, such as dementia with Lewy bodies, in elderly patients presenting with altered consciousness.
  • Neuroimaging techniques like SPECT and PET can be crucial in diagnosing neurodegenerative conditions that may manifest with episodic neurological symptoms.
Keywords:
dementia, alzheimer’s typeepilepsy and seizuresgeriatric medicinememory disorders (psychiatry)

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