Case Report: Lewy body dementia with unusual psychotic symptoms, atypically late parkinsonism, and patient sensitivity to first generation antipsychotics

Lewy body dementia is associated with abnormal eosinophilic A-synuclein neural inclusions (Lewy bodies) in the brain. It is a neurodegenerative illness—and the second most common type of dementia after Alzheimer’s disease—that causes memory loss and severe problems in carrying out daily activities....

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Main Authors: Lolita Ercika, Maris Taube
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Psychiatry
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Online Access:https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1551581/full
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author Lolita Ercika
Lolita Ercika
Maris Taube
Maris Taube
Maris Taube
author_facet Lolita Ercika
Lolita Ercika
Maris Taube
Maris Taube
Maris Taube
author_sort Lolita Ercika
collection DOAJ
description Lewy body dementia is associated with abnormal eosinophilic A-synuclein neural inclusions (Lewy bodies) in the brain. It is a neurodegenerative illness—and the second most common type of dementia after Alzheimer’s disease—that causes memory loss and severe problems in carrying out daily activities. In this report, we describe a case of Lewy body dementia that began with early psychotic symptoms with atypical features (transition from hallucinosis (hallucinatory insight) to true visual hallucinations) —without Parkinsonism. The patient exhibited sensitivity to first generation antipsychotic medication, which led to a worsening of her symptoms. Physicians should consider all possible diagnoses when confronted with atypical, early symptoms of visual hallucinosis or true hallucinations and dementia without Parkinsonism. Choosing antipsychotic medicines should be made with care given these patients’ possible sensitivity to antipsychotics. The selection of antipsychotics should be consider among first, second and third generation options.
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publisher Frontiers Media S.A.
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spelling doaj-art-44c23a00cf4c42de9b81111d8b5cb0eb2025-08-20T02:08:35ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402025-04-011610.3389/fpsyt.2025.15515811551581Case Report: Lewy body dementia with unusual psychotic symptoms, atypically late parkinsonism, and patient sensitivity to first generation antipsychoticsLolita Ercika0Lolita Ercika1Maris Taube2Maris Taube3Maris Taube4Faculty of Residency, Riga Stradiņš University, Riga, LatviaDepartment of Depression and Crisis, National Center of Mental Health, Riga, LatviaFaculty of Residency, Riga Stradiņš University, Riga, LatviaDepartment of Depression and Crisis, National Center of Mental Health, Riga, LatviaDepartment of Psychosomatic Medicine and Psychotherapy, Riga Stradiņš University, Riga, LatviaLewy body dementia is associated with abnormal eosinophilic A-synuclein neural inclusions (Lewy bodies) in the brain. It is a neurodegenerative illness—and the second most common type of dementia after Alzheimer’s disease—that causes memory loss and severe problems in carrying out daily activities. In this report, we describe a case of Lewy body dementia that began with early psychotic symptoms with atypical features (transition from hallucinosis (hallucinatory insight) to true visual hallucinations) —without Parkinsonism. The patient exhibited sensitivity to first generation antipsychotic medication, which led to a worsening of her symptoms. Physicians should consider all possible diagnoses when confronted with atypical, early symptoms of visual hallucinosis or true hallucinations and dementia without Parkinsonism. Choosing antipsychotic medicines should be made with care given these patients’ possible sensitivity to antipsychotics. The selection of antipsychotics should be consider among first, second and third generation options.https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1551581/fulldementiaLewi bodiespsychosisantipsychoticssensitivity
spellingShingle Lolita Ercika
Lolita Ercika
Maris Taube
Maris Taube
Maris Taube
Case Report: Lewy body dementia with unusual psychotic symptoms, atypically late parkinsonism, and patient sensitivity to first generation antipsychotics
Frontiers in Psychiatry
dementia
Lewi bodies
psychosis
antipsychotics
sensitivity
title Case Report: Lewy body dementia with unusual psychotic symptoms, atypically late parkinsonism, and patient sensitivity to first generation antipsychotics
title_full Case Report: Lewy body dementia with unusual psychotic symptoms, atypically late parkinsonism, and patient sensitivity to first generation antipsychotics
title_fullStr Case Report: Lewy body dementia with unusual psychotic symptoms, atypically late parkinsonism, and patient sensitivity to first generation antipsychotics
title_full_unstemmed Case Report: Lewy body dementia with unusual psychotic symptoms, atypically late parkinsonism, and patient sensitivity to first generation antipsychotics
title_short Case Report: Lewy body dementia with unusual psychotic symptoms, atypically late parkinsonism, and patient sensitivity to first generation antipsychotics
title_sort case report lewy body dementia with unusual psychotic symptoms atypically late parkinsonism and patient sensitivity to first generation antipsychotics
topic dementia
Lewi bodies
psychosis
antipsychotics
sensitivity
url https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1551581/full
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