[Treatment of Dementia with Lewy Bodies from a Neurological Perspective]

Dementia with Lewy bodies (DLB) can lead to pronounced behavioral and psychological symptoms. A 75-year-old woman presented with forgetfulness and visual hallucination, frequently reporting that a man in white clothing appeared and then departed. On one occasion, she knocked on a resident's door in an apartment building, prompting a police call from the occupant. Treatment with donepezil and memantine proved effective; however, the symptoms improved with the initiation of day care. An 80-year-old woman exhibited incoherent speech and developed optical illusions. She occasionally displayed violent behavior at night, asserting that an intruder was present in the home. Two years later, during a nighttime episode, she perceived her husband as a stranger and bit him. The husband contacted the police, resulting in her admission to a psychiatric hospital. Both patients received exclusive care from the neurology department. Referrals to neurologists typically occur when behavioral and psychological symptoms predominate or when families request psychological intervention. Referrals to psychiatry are primarily used to treat parkinsonism. Electroconvulsive therapy is indicated when both symptom types reach severe levels. Neurologists and psychiatrists provide the most effective treatment for Lewy body dementia.