P4‐042: Dementia with lewy bodies manifested as delusional parasitosis (Ekbom's syndrome)

Magierski, Radosław; Magierska, Joanna; Kłoszewska, Iwona; Sobów, Tomasz

doi:10.1016/j.jalz.2015.06.1746

Cited by 5 publications

(7 citation statements)

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“…Both patients had visual hallucinations, which is one of the core clinical features of DLB. Among four prior cases of delusional infestation diagnosed with DLB, two patients had visual hallucinations (7)(8)(9). Even in cases of suspected dementia in which a diagnosis of DLB had not been made, the coexistence of complex visual hallucinations and delusional infestation have been reported (15)(16)(17).…”

Section: Discussionmentioning

confidence: 99%

Case report: Delusional infestation in dementia with Lewy bodies

Taomoto

Kanemoto²,

Satake³

et al. 2022

Front. Psychiatry

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BackgroundDelusional infestation is characterized by delusions of being infested with parasites, vermin, or small insects and is frequently accompanied by tactile and visual hallucinations. Herein, we report two cases of dementia with Lewy bodies (DLB) with delusional infestation.Case presentationCase 1 was an 83-year-old man. At the age of 75, he began to show symptoms of rapid eye movement sleep behavior disorder. At the age of 83, he began to complain of visual hallucinations of people and delusional infestation with tactile and visual hallucinations of insects, resulting in the use of insecticides for non-existent insects. He also complained of mild amnesia and was admitted to our psychiatric ward for evaluation and treatment. After admission, the delusional infestation disappeared without any new medication. Based on our examinations, he was diagnosed with probable DLB with delusional infestation. He was treated with 5 mg/day of donepezil hydrochloride; his visual and tactile hallucinations disappeared, and the delusional infestation had not recurred at the 1-year follow-up. Case 2 was a 69-year-old woman. At the age of 60, she underwent clipping for subarachnoid hemorrhage (SAH). At the age of 65, she began to have visual hallucinations of people. At the age of 67, she began to complain of visual illusions in which she mistook lint for insects. At the age of 69, she developed delusional infestation and mild amnesia. She took various actions to get rid of these non-existent insects, including insecticide use, consulting an exterminator, and visiting several dermatologists. She eventually burnt her leg in an attempt to kill the non-existent insects. Based on our examinations, she was diagnosed with prodromal DLB in addition to SAH sequelae. We determined that her delusional infestation was caused by DLB rather than SAH sequelae based on the course of her symptoms. She was treated with a combination of 3 mg/day of donepezil hydrochloride and 12.5 mg/day of quetiapine. Thereafter, the delusional infestation partially improved, and she took no further action against non-existent insects.ConclusionDelusional infestation may be caused by DLB. Acetylcholinesterase inhibitors (AChEI) may be effective for delusional infestation in DLB, although antipsychotics may also be needed in severe cases.

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Section: Discussionmentioning

confidence: 99%

Case report: Delusional infestation in dementia with Lewy bodies

Taomoto

Kanemoto²,

Satake³

et al. 2022

Front. Psychiatry

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“…More than 50% of these patients develop delusions in the mild stages (clinical dementia rating, 0.5) ( 20 ). There have been some reports on patients with DLB and unusual delusions, such as Othello syndrome ( 11 ), delusional parasitosis ( 21 , 22 ) and delusion of duplication ( 23 ). In particular, Othello syndrome, characterized by delusional beliefs of infidelity of a partner, was known to be found in as much as 26.3% of DLB ( 11 ).…”

Section: Discussionmentioning

confidence: 99%

Case Report: De Clerambault's Syndrome in Dementia With Lewy Bodies

et al. 2021

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Background: Erotomania, also known as de Clerambault's syndrome, is characterized by the delusion that a person has fallen in love with the patient. It occasionally appears secondary to psychiatric disorders and organic brain diseases. However, there have been no reports on cases secondary to dementia with Lewy bodies (DLB).Case Presentation: The patient was an 83-year-old woman who lived alone. Mild cognitive impairment appeared at the age of 82 years. Soon after, she had the delusional conviction that her family doctor was in love with her. Her symptoms, such as gradually progressive cognitive impairment, cognitive fluctuations, and parkinsonism, indicated DLB. She was treated with a small dose of antipsychotic agents.Conclusions: This case report suggests the possibility of de Clerambault's syndrome during the early stages of DLB. Further investigations are required to clarify the mechanism and treatment of de Clerambault's syndrome in patients with DLB.

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“…In our recent study, the frequency of delusion in DLB patients was 54.8% (68/124), top three of delusions were phantom boarder delusion, delusion of theft and persecution, and there was no case of delusional parasitosis [10]. Delusional parasitosis is rare in DLB, and there is only one case report [11]. Considering that organic brain disease including dementia is one of the potential aetiologies of secondary delusional parasitosis [8], delusional parasitosis could be present in DLB.…”

Section: Discussionmentioning

confidence: 99%

“…As well as systematized delusions, severe sensitivity to antipsychotic agents has been identified as one of the supportive clinical features in DLB [3]. In the previous report, quetiapine and olanzapine were successful for the treatment of DLB with delusional parasitosis [11]. Aripiprazole has a unique pharmacological profile acting as a dopamine D2 receptor partial agonist, which has been posited to reduce the risk of extrapyramidal symptoms [12].…”

Section: Discussionmentioning

confidence: 99%

Delusional parasitosis in dementia with Lewy bodies: a case report

et al. 2019

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BackgroundDementia with Lewy bodies (DLB) is characterized by fluctuating cognitive impairments, recurrent visual hallucinations, the motor symptoms of parkinsonism and REM sleep behavior disorder. Various neuropsychiatric symptoms including hallucination and delusions occur frequently; however, delusional parasitosis is rare in DLB. Here, we report a case of DLB patient with delusional parasitosis.Case presentationThe patient was an 89-year-old woman. At the age of 88, she began to complain her oral cenesthopathy, and developed cognitive decline, delusional parasitosis and parkinsonism. As a result of examination, she was diagnosed as DLB and treated with combination of donepezil 5 mg/day and aripiprazole 1.5 mg/day, and her complaint was disappeared.ConclusionsFurther studies are needed to investigate the association between delusional parasitosis and underlying pathophysiology of DLB, and the utility of antipsychotics for delusional parasitosis in DLB has to be examined through more cases.

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P4‐042: Dementia with lewy bodies manifested as delusional parasitosis (Ekbom's syndrome)

Cited by 5 publications

References 0 publications

Case report: Delusional infestation in dementia with Lewy bodies

Case report: Delusional infestation in dementia with Lewy bodies

Case Report: De Clerambault's Syndrome in Dementia With Lewy Bodies

Delusional parasitosis in dementia with Lewy bodies: a case report

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