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Re: 3 main LBD symptoms

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Hi ,

I'm so very sorry you and your wife are having to deal with anything like

LBD. I'm not sure where she is being evaluated, but I would strongly

suggest she be thoroughly evaluated at a Memory Clinic. There are many

across the united states and Canada and they are well versed in diagnosing

and distinguishing between other possible causes.

We took my mother in law to the one in San Francisco, UCSF Memory and Aging

Clinic, after many frustrating years of not fully understanding what we were

dealing with. They provided a whole team approach to her evaluation and

eventual diagnosis and a proactive plan for managing the illness and

symptoms. They have been there for us when we needed additional help and

understanding also. No doctor mentioned LBD to us though reading about

various forms of dementia I thought it might be possible. Certainly I could

see she had the stiffness and balance issues that could be Parkinson's.

Here is a link to the a list of the memory centers in the united states

(below). Most insurance is cooperative in covering an evaluation and the

centers will be able to help with this also. I would suggest finding one

close to you and calling to see if it's something you could manage. The

doctors we saw at the one in SF were amazing - compassionate, well educated

and up to date on neurology issues in general and dementia issues

specifically and there are several psychiatrists on staff as well.

My personal opinion about what you have written on 3 symptoms is there is

nothing I have seen with people with this disease so far that is that cut

and dry. There are variations I have seen personally and read about here in

this support group and others. What I know tells me it is not really

possible to have a diagnosis between those three based on those 3 things.

Further, LBD is frequently (I hesitate to say always but from what I have

seen it has been both) accompanied with Parkinson's or " Parkinsonism " and

most LBD diagnosis I have seen have this noted in the dx. My mil has not

had terrible hallucinations with LBD. She has had some disturbing and also

interesting delusions. Others have had terrible hallucinations - like dead

bodies and so on - just terrifying things. My mil used to sleep well

through the night early in the disease. For the last three years however

she rarely sleeps, when it's bedtime she perks up and wants to stay awake

and yells " help me. " all night long endlessly. It's horrible and she's

been doing it for over two years now. She has had the fluctuations in

cognitive ability for at least 5 years and she does have good days and bad

days - however she also has times that are more stable and instead of days

had good weeks/months and bad weeks/months. And sometimes she gets into a

groove and chugs along with it seeming somewhat stable for awhile then

something else slips and she's wanting me to call and order what she saw

them cooking on the television or tell her who that strange woman is that

keeps wanting her to drink water and when can she go to her own room. She

has always had walking problems (that is the Parkinson's part with her).

She has cognitive difficulty in some things. Her reasoning ability was shot

long ago. She does experience delusions with paranoia and gets into

resulting panic attacks yelling and hyperventilating and seeming to be

convinced something happened to her son but we aren't telling her, etc.

I sure wish you all the luck to get a diagnosis and help you need. I'm so

very sorry you and your wife are having to deal with this. This is a very

helpful and compassionate support group and hope you will find what you need

here.

Dorothy

Memory Centers/Clinics - United States

http://alzheimersolutions.stores.yahoo.net/rescen.html

From: LBDcaregivers [mailto:LBDcaregivers ]

On Behalf Of gary.s.dale@...

Sent: Monday, September 05, 2011 10:20 PM

To: LBDcaregivers

Subject: 3 main LBD symptoms

I have read that these 3 symptoms are what separate LBD from PD and

Alzheimer's: 1. patients have detailed and vivid Hallucinations early in the

disease. 2. people with LBD show marked fluctuations in their cognitive

functioning- sometimes referred to as 'good days' 'bad days'. 3. Lbd has

EDS(excessive daytime sleeping) and have restless, disturbed sleep w/

behavioral acting out, at night. How important is it to have these symptoms

to have LBD? Can you caregivers out there tell me if that is what you

experience with your LO ? Is my wife's doctor missing something ? She hasn't

had hallucinations, doesn't have good days and then bad days, and she sleeps

like a log at night. She has cognitive problems, walking problems, and had

delusions with paranoia. She has never had those 3 main symptoms. She is on

various meds and they gave her ECT in the hospital for psychotic depression

before he came up with possible LBD?? Anyone know if ECT can damage your

brain?! The video they will show you makes it sound harmless and a slam dunk

cure for serious depression. Any thoughts would be helpful. .........gary

(wife Kay-age 59- going on 2 years with something terrible)

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Have they ruled out NPH?

Normal Pressure Hydrocephalus (NPH)

Normal pressure hydrocephalus (NPH) is an accumulation of cerebrospinal fluid

that causes the ventricles in the brain to become enlarged with little or no

increase in pressure. The name of this condition is misleading, however, because

some patients have fluctuations of CSF pressure from high to normal to low. In

most cases of NPH, it is not clear what causes the CSF pathways to become

blocked.

http://www.hydroassoc.org/information/nph.html

>

> I have read that these 3 symptoms are what separate LBD from PD and

Alzheimer's: 1. patients have detailed and vivid Hallucinations early in the

disease. 2. people with LBD show marked fluctuations in their cognitive

functioning- sometimes referred to as 'good days' 'bad days'. 3. Lbd has

EDS(excessive daytime sleeping) and have restless, disturbed sleep w/

behavioral acting out, at night. How important is it to have these symptoms to

have LBD? Can you caregivers out there tell me if that is what you experience

with your LO ? Is my wife's doctor missing something ? She hasn't had

hallucinations, doesn't have good days and then bad days, and she sleeps like

a log at night. She has cognitive problems, walking problems, and had delusions

with paranoia. She has never had those 3 main symptoms. She is on various meds

and they gave her ECT in the hospital for psychotic depression before he came up

with possible LBD?? Anyone know if ECT can damage your brain? The video they

will show you makes it sound harmless and a slam dunk cure for serious

depression. Any thoughts would be helpful. .........gary (wife Kay-age 59-

going on 2 years with something terrible)

>

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and others

My moms md said as many have seconded that LBD can only be diagnoses for certain

at autopsy

Bit

My moms was diagnosed with LBD Since

1. Her motor problems that were Parkinsonism did not include a lot of tremors

and rather marked by imbalance which also led to many falls

2. Her cognition declined rapidly shortly after the motor issues although these

were highlighted with lack of judgment and the hallucinations were few but not

evil and rather sweet - like " all the Spanish people are praying for me on the

living room " and

" mr and mrs old friends are living across the hall "

3. Her rapid motor and cognitive decline did not respond to the usual drugs like

levedopa and the excellon patch

In short it was parkinsons gone very wrong very quick and severe dementia

Hope that helps -

Judy R. Strauss LMSW PhD

Lead Faculty

University of Phoenix

Jersey City Campus

100 Town Square Place

|Jersey City, NJ 07310

Cell-

Email- Jrstr@...

> Have they ruled out NPH?

>

> Normal Pressure Hydrocephalus (NPH)

> Normal pressure hydrocephalus (NPH) is an accumulation of cerebrospinal fluid

that causes the ventricles in the brain to become enlarged with little or no

increase in pressure. The name of this condition is misleading, however, because

some patients have fluctuations of CSF pressure from high to normal to low. In

most cases of NPH, it is not clear what causes the CSF pathways to become

blocked.

> http://www.hydroassoc.org/information/nph.html

>

>

> >

> > I have read that these 3 symptoms are what separate LBD from PD and

Alzheimer's: 1. patients have detailed and vivid Hallucinations early in the

disease. 2. people with LBD show marked fluctuations in their cognitive

functioning- sometimes referred to as 'good days' 'bad days'. 3. Lbd has

EDS(excessive daytime sleeping) and have restless, disturbed sleep w/ behavioral

acting out, at night. How important is it to have these symptoms to have LBD?

Can you caregivers out there tell me if that is what you experience with your LO

? Is my wife's doctor missing something ? She hasn't had hallucinations, doesn't

have good days and then bad days, and she sleeps like a log at night. She has

cognitive problems, walking problems, and had delusions with paranoia. She has

never had those 3 main symptoms. She is on various meds and they gave her ECT in

the hospital for psychotic depression before he came up with possible LBD??

Anyone know if ECT can damage your brain? The video they will show you makes it

sound harmless and a slam dunk cure for serious depression. Any thoughts would

be helpful. .........gary (wife Kay-age 59- going on 2 years with something

terrible)

> >

>

>

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,

I've probably helped 60 LBD families accomplish brain donations of their loved

ones. These are loved ones with a clinical diagnosis of LBD whose brains were

donated upon death to determine the definitive diagnosis. Half did not have LBD

upon brain autopsy. Nearly all of those who did not have LBD did not experience

visual hallucinations.

All with LBD had fluctuating cognition.

Some, but not all, had RBD. EDS was less common. Neither RBD nor EDS are

considered core symptoms of LBD.

You didn't mention if your wife has the central symptom of LBD -- dementia.

Besides the central symptom, the three core LBD symptoms are visual

hallucinations, fluctuating cognition, and parkinsonism. You must have two of

the three to be diagnosed with probable LBD. It seems that your wife doesn't

have any of the three core symptoms.

I think there's no evidence that ECT can cause dementia. Of course depression

and dementia are highly associated.

There are many, many non-Alzheimer's dementias. A handful are reversible. If

your wife has dementia, I suggest you see a dementia specialist. See an expert

at one of the top institutions. Only a handful of the dementing illnesses can

be confirmed during life; nearly all require a brain autopsy for definitive

confirmation. The diagnostic accuracy rate of most dementias (including AD) is

less than 50%.

Good luck,

Robin

>

> I have read that these 3 symptoms are what separate LBD from PD and

Alzheimer's: 1. patients have detailed and vivid Hallucinations early in the

disease. 2. people with LBD show marked fluctuations in their cognitive

functioning- sometimes referred to as 'good days' 'bad days'. 3. Lbd has

EDS(excessive daytime sleeping) and have restless, disturbed sleep w/

behavioral acting out, at night. How important is it to have these symptoms to

have LBD? Can you caregivers out there tell me if that is what you experience

with your LO ? Is my wife's doctor missing something ? She hasn't had

hallucinations, doesn't have good days and then bad days, and she sleeps like

a log at night. She has cognitive problems, walking problems, and had delusions

with paranoia. She has never had those 3 main symptoms. She is on various meds

and they gave her ECT in the hospital for psychotic depression before he came up

with possible LBD?? Anyone know if ECT can damage your brain? The video they

will show you makes it sound harmless and a slam dunk cure for serious

depression. Any thoughts would be helpful. .........gary (wife Kay-age 59-

going on 2 years with something terrible)

>

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Robin,

Thanks for your post. It is very helpful to understand what has been " seen "

later in these patients. I am curious, were there any instances of visual

hallucinations that ended up not being LBD on autopsy? Do you know other

reasons for hallucinations. My mom does have hallucinations (that sound like

they type described for LBD) and maybe some fluctating cognition but for the

most part still seems so normal. She has always been over-dramatic in

describing things, so it is hard for me to discern whether she is really

experiencing fluctuating cognition. I tend to see any differences to be related

whether she is in a good mood (always the case when she is busy and active) or a

bad mood (depressed because she is lonely). Can you help me understand a little

bit better about what fluctuating cognition " looks " like and/or how I might

figure out if she is really experiencing this or just experiencing normal

variations.

Thanks again for your insight.

Sherri

> >

> > I have read that these 3 symptoms are what separate LBD from PD and

Alzheimer's: 1. patients have detailed and vivid Hallucinations early in the

disease. 2. people with LBD show marked fluctuations in their cognitive

functioning- sometimes referred to as 'good days' 'bad days'. 3. Lbd has

EDS(excessive daytime sleeping) and have restless, disturbed sleep w/

behavioral acting out, at night. How important is it to have these symptoms to

have LBD? Can you caregivers out there tell me if that is what you experience

with your LO ? Is my wife's doctor missing something ? She hasn't had

hallucinations, doesn't have good days and then bad days, and she sleeps like

a log at night. She has cognitive problems, walking problems, and had delusions

with paranoia. She has never had those 3 main symptoms. She is on various meds

and they gave her ECT in the hospital for psychotic depression before he came up

with possible LBD?? Anyone know if ECT can damage your brain? The video they

will show you makes it sound harmless and a slam dunk cure for serious

depression. Any thoughts would be helpful. .........gary (wife Kay-age 59-

going on 2 years with something terrible)

> >

>

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