Lewy body dementia is a progressive neurodegenerative disease and is considered
to be the second most common cause of dementia in the elderly. Because of the complexity of clinical
presentation, it is often misdiagnosed and mistaken for other dementias, which may result in administering
inappropriate therapy, and thus worsening of the patient condition. We reviewed a case of a
71-year-old patient whose clinical presentation gradually occurred with complex visual hallucinations,
atypical extrapyramidal motor symptoms, fluctuating cognitive impairments with delirious episodes,
and oscillating syncope. Depressive mood, impaired daily functioning and sensitivity to antipsychotics
were also noted. Extensive diagnostic workup was performed with neuropsychological testing and use
of single-photon emission computerized tomography. Considering the clinical presentation and diagnostic
procedures performed, the diagnosis of Lewy body dementia was set and pharmacotherapy was
revised. We discuss the importance of taking overall clinical presentation and diagnostic treatment in
consideration and applying appropriate therapy to slow down the progression of the disease and exacerbation
of the patient’s psychological functions.Demencija Lewyjevih tjelešaca je neurodegenerativna bolest i drugi najčešći uzročnik demencije u starijih osoba. Zbog
složenosti kliničke slike često se pogrešno dijagnosticira i nerijetko zamijeni s drugim demencijama, što dovodi do primjene
neodgovarajuće terapije, a time i pogoršanja stanja bolesnika. Prikazujemo slučaj bolesnika u dobi od 71 godine kod kojega
se klinička slika postupno prezentirala složenim vizualnim halucinacijama, atipičnim ekstrapiramidnim motoričkim ispadima,
fluktuirajućim kognitivnim smetnjama uz delirantne epizode i oscilirajuće sinkope. Kod bolesnika je zabilježeno depresivno
raspoloženje, narušeno svakodnevno funkcioniranje i osjetljivost na psihofarmake. Provedena je opširna dijagnostička
obrada uz neuropsihologijsko testiranje i primjenu jednofotonske emisijske tomografije. Na temelju kliničke slike i diferencijalno
dijagnostičke obrade posumnjalo se na demenciju Lewyjevih tjelešaca. Raspravljamo o važnosti uzimanja u obzir
cjelokupne kliničke slike i dijagnostičke obrade te primjeni odgovarajućeg liječenja u svrhu prevencije progresije bolesti i
pogoršanja psihičkih funkcija bolesnika
