Cognición y enfermedad por cuerpos de Lewy / Cognition and lewy body disease

Introducción. Asistimos en los últimos años a un cambio importante en las manifestaciones clínicas de la Enfermedad de Parkinson (EP). Los problemas motores para los que hoyen día existen mejores tratamientos que hace unas décadas, han dado paso a manifestaciones no motoras como principal fuente de incapacidad en la EP avanzada, siendo el deterioro cognitivo la más grave por su prevalencia y devastadoras consecuencias. Caso Clínico. Presentamos el caso de una paciente mujer de 72 años que llega a nuestro servicio aludiendo quejas de tipo cognitivo y depresivas, posiblemente compatibles con un síndrome depresivo, y a la que finalmente se diagnostica de Enfermedad por Cuerpos de Lewy pese a ser dichas manifestaciones cognitivas más propias de los cuadros avanzados. Conclusión. Mostrar un caso clínico de Enfermedad por Cuerpos de Lewy de interés por su sintomatología incipiente de tipo cognitivo (de interés para la valoración psiquiátrica), de tipo motor o parkinsonianos (de interés para la valoración neurológica) y de tipo orgánico, a la luz de las pruebas complementarias efectuadas. Asimismo, justificamos el uso de la rivastigmina como tratamiento de elección para este tipo de cuadros de Enfermedad por Cuerpos de Lewy que debutan con sintomatología cognitiva (AU)

Introduction. We’re assisting in last years to an important change in clinical manifestations of Parkinson disease. Nowadays motor symptoms have best treatments if we compare with those existing some decades ago, which in last term, permits other manifestations being the main disabilities in an advanced Parkinson disease. Among these disabilities cognitives are the most severe due to it’s prevalence and devastating consecuences. Clinical Case. We present the clinical case of a 72 aged woman who complains of cognitive and depressive symptoms, probably compatible with a depressive disorder, but finally diagnosed with Lewy body disease despite these cognitive manifestations are most common in advanced disease. Conclusions. We’ re showing an interesting case of Lewy body disease due to it’s incipient symptomatology in cognitive manifestations (which makes it interesting for psichiatric value), motor manifestations (interesting for neurological value) and organic manifestations as complementary tests demostrate. Finally, we justificate the usage of rivastigmine as the choice of treatment in these cases which onset is mainly composed by cognitive symptoms (AU)

Cognition and Lewy body disease.

INTRODUCTION: We're assisting in last years to an important change in clinical manifestations of Parkinson disease. Nowadays motor symptoms have best treatments if we compare with those existing some decades ago, which in last term, permits other manifestations being the main disabilities in an advanced Parkinson disease. Among these disabilities cognitives are the most severe due to it's prevalence and devastating consecuences. CLINICAL CASE: We present the clinical case of a 72 aged woman who complains of cognitive and depressive symptoms, probably compatible with a depressive disorder, but finally diagnosed with Lewy body disease despite these cognitive manifestations are most common in advanced disease. CONCLUSIONS: We' re showing an interesting case of Lewy body disease due to it's incipient symptomatology in cognitive manifestations (which makes it interesting for psichiatric value), motor manifestations (interesting for neurological value) and organic manifestations as complementary tests demostrate. Finally, we justificate the usage of rivastigmine as the choice of treatment in these cases which onset is mainly composed by cognitive symptoms. Key words: Parkinson, Lewy Bodies, dementia, cognitive impairment, rivastigmine, dopamine.