Report on 4 cases which can be diagnosed as Probable DLB, but did not lose the accumulation of MIBG in the heart, and had epileptiform discharge in the temporal lobe

Report on 4 cases which can be diagnosed as Probable DLB, but did not lose the accumulation of MIBG
in the heart, and had epileptiform discharge in the temporal lobe

Kazumasa Shiozaki^1,4), Tomoko Nishio^1,4), Satoshi Kajihara^1,3), Miyuki Nagase²⁾,
Yasuko Kawagoe¹⁾, Yoshiko Furukawa¹⁾, Hideo Iwanari¹⁾

¹⁾Department of Psychiatry and ²⁾Department of Radiology, Yokohama Comprehensive Care Continuum
³⁾Kajihara Mental Clinic
⁴⁾Department of Psychiatry, School of Medicine, Yokohama City University

Dementia with Lewy bodies (DLB) is a common dementia with characteristic psychiatric symptoms such as visual hallucination and REM sleep behavior disorder (RBD). We experienced 4 cases diagnosed as probable DLB on diagnostic criteria but they did not show a decline of ¹²³-I-MIBG accumulation in hearts, which is considered to be the sensitive and specific remark as DLB. On the other hand, epileptiform discharge was detected in the temporal lobe in all 4 cases, and symptoms considered as visual hallucination and RBD were partially led to remission by antiepileptic drugs. The visual hallucination and RBD-like symptoms in these cases were considered symptoms of partial seizures of epilepsy. In the diagnosis of DLB, differential diagnosis of temporal lobe epilepsy with similar symptoms is necessary, and electroencephalogram examination should be positively carried out.

Address correspondence to Dr. Kazumasa Shiozaki, Department of Psychiatry, Yokohama Comprehensive Care Continuum (1735 Toriyama-cho, Kouhoku-ku, Yokohama 222-0035, Japan)