Impact of surgery on Lewy body dementia: two cases presentation

Year 2017, , 88 - 91, 02.03.2017

Bekir Enes Demiryürek Bilgehan Atılgan Acar Mustafa Ceylan Esra Demiryürek Selçuk Yaylacı

https://doi.org/10.21601/ortadogutipdergisi.293150

Abstract

Lewy body dementiaisa neurodegenerative dementing disorder. It is most common form of dementia
after Alzheimer’sdisease. Dementia with Lewy bodies is primarily characterized as
cognitive decline, visual hallucinations and motor features (parkinsonism).
Other clinical symptoms include REM (rapid eye movement) sleep behavior disorder, serious neuroleptic sensitivity and dysautonomia
support diagnosis. Both postoperative cognitive deficit and post operatif
delirium are more common in elderly patients with Lewy body dementia than
normal elderly patients and elderly patients with other dementias such as
Alzheimer disease.We presented women cases;
first case 65years old occured post operatif cognitif deficity and postoperative
hypoactive delirium after pelvic fracture operation and the other one 60 years old
occurred postoperative cognitive deficit and postoperative hyperactive delirium
after appendicitis surgery. In patients
with Lewy body dementia, early diagnosis and treatment of surgery complications
are very effective to prevent morbidity and mortality.
Also clinicans should determine and reduce probable risks of
preoperative and intraoperative complications in patients with Lewy body dementia.

Keywords

Lewy body dementia, surgery, cognition, delirium

Cerrahi girişimlerin Lewy body demansa etkisi: iki olgu sunumu

Abstract

Lewy body demans Alzheimer hastalığından sonra ikinci
sıklıkta görülen nörodejeneratif demanstır.
Kardinal bulguları bilişsel
bozukluk, görsel halüsinasyonlar ve
motor bulgular (parkinsonizm)dır. Aynı
zamanda REM (rapid
eye movement) uyku davranış bozukluğu ve ciddi
nöroleptik duyarlılığı ve disotonominin
varlığı tanıyı destekleyici bulgulardır.

Lewy body demans
tanılı olgularda post operatif bilişsel bozuklukta artış ve
post operatif deliryum normal yaşlı populasyonu ile Alzheimer hastalığı ve diğer
demans olgularına göre daha sık görülmektedir.
Bu yazıda biri 65 yaşında kalça kırığı nedeniyle cerrahi operasyon
sonrası hipoaktif deliryum ve sonrasında
bilişsel fonksiyonlarda bozulmada artış gözlenen, diğeri 60 yaşında sonrası hiperaktif deliryum ve bilişsel bozulmada artış gözlenen iki adet erkek olası Lewy body demans olgusu sunduk.
Lewy body demans olgularında cerrahi sonrası komplikasyonların erken tanısı ve
tedavisinin ciddi morbidite ve mortaliteyi
önlemede oldukça etkin olduğu akılda tutulmalıdır.
Ayrıca klinisyenler Lewy body demans olgularında preoperatif ve intraoperatif dönemde komplikasyon gelişimini
azaltmak için olası riskleri saptamalı ve en aza indirgemeye çalışmalıdırlar.

Keywords

Lewy body demans, cerrahi, bilişsel fonksiyon, deliryum

References

• Prince M, Bryce R, Albanese E, Wimo A, Ribeiro W, Ferri CP. The global prevalence of dementia: a systematic review and meta analysis. Alzheimers Dement. 2013;9:63-75
• Colette W, Nancy E, Rosanne G, Karen Y. Differentiating Alzheimer disease, Lewy body, and Parkinson dementia using DSM-5. J NursePract. 2014;10:262-70.
• Farzana Pervin, Carolyn Edwards, Carol F. Lippa. Dementia With Lew Body: Impacts of Surgery. Am J Alzheimers Dis Other De- men. 2016;31:5-17.
• Greicius MD, Geschwind MD, Miller BL. Presenile dementia syndromes: an update on taxonomy and diagnosis. J Neurol Neu- rosurg Psychiatry. 2002;72:691-700.
• Hu CJ, Liao CC, Chang CC, Wu CH, Chen TL. Postoperative ad- verse outcomes in surgical patients with dementia: a retrospective cohort study. World J Surg. 2012;36:2051-8.
• Bilotta F, Doronzio A, Stazi E, et al. Postoperative cognitive dysfunction: toward the Alzheimer’s disease patho mechanism hypothesis. J AlzheimersDis. 2010;22:81-9.
• Snowdon DA, Greiner LH, Mortimer JA, Riley KP, Greiner PA, Markesbery WR. Brain infarction and the clinical expression of Alzheimer disease. The nun study. JA-MA. 1997; 277:813-7.
• Webster NJ, Green KN, Settle VJ, Peers C, Vaughan PF. Altered processing of the amyloid precursor protein and decreased expres- sion of ADAM 10 by chronic hypoxia in SH-SY5Y: no role for the stress-activated JNK and p38 signalling pathways. Mol Brain Res. 2004; 130:161-9.
• Vardy E, Holt R, Gerhard A, Richardson A, Snowden J, Neary D. History of a suspected delirium is more common in dementia with Lewy bodies than Alzheimer’s disease: a retrospective study. Int J Geriatr Psychiatry. 2014; 29:178-81.
• Downing LJ, Caprio TV, Lyness JM. Geriatric psychiatry review: differential diagnosis and treatment of the 3 D’s—delirium, de- mentia and depression.Curr Psychiatry Rep. 2013; 15:365.