Neuroleptic Malignant Syndrome and Dementia with Lewy Bodies

The clinical criteria for Dementia with Lewy bodies (DLB) as proposed by the International Working Group include neuroleptic hypersensitivity as a “supportive feature” (McKeith et al., 1996). The spectrum of this neuroleptic hypersensitivity continues to be elucidated, as cases are reported where the use of neuroleptics has been associated with a dramatically accelerated rate of decline and death (McKeith et al., 1992a). This observation emerges on the more general background of elderly patients having a greater risk to develop fatal Neuroleptic Malignant Syndrome (NMS) particularly in the context of underlying neurologic disease (Shalev and Munitz, 1986; Pearlman, 1986). In the descriptions of severe neuroleptic hypersensitivity in DLB, NMS has been reported as part of the DLB hypersensitivity spectrum. The incidence of NMS in the setting of dementia with Lewy bodies is not presently known. Similarly, the effects of neuroleptic use in younger patients with DLB and the risks of NMS are not fully characterized.

Authors and Affiliations

1. Division of Neurology, University of British Columbia and The Clinic for Alzheimer’s Disease and Related Disorders, Vancouver Hospital and HSC, Vancouver, Canada

   Howard Feldman

2. Division of Geriatric Psychiatry, Riverview Hospital and University of British Columbia Vancouver, Canada

   Kevin Solomons

3. Department of Anatomical Pathology, Royal Columbian Hospital, New Westminster, Canada

   Tom Cooney

4. Division of Neuropathology, University of British Columbia Vancouver Hospital and HSC, Vancouver, Canada

   Thomas G. Beach

Editors and Affiliations

1. Israel Institute for Biological Research, Ness Ziona, Israel

   Abraham Fisher

2. Loyola University of Chicago, Maywood, Illinois, USA

   Israel Hanin

3. Jichi Medical School, Tochigi, Japan

   Mitsuo Yoshida

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