Delusional parasitosis in dementia with Lewy bodies: a case report
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Annals of General Psychiatry Open Access
CASE REPORT
Delusional parasitosis in dementia with Lewy bodies: a case report Sho Ochiai1, Hiroko Sugawara1*, Yusuke Kajio2, Hibiki Tanaka1, Tomohisa Ishikawa1, Ryuji Fukuhara1, Tadashi Jono1,3 and Mamoru Hashimoto4
Abstract Background: Dementia 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 presentation: The 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. Conclusions: Further 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. Keywords: DLB, Delusional parasitosis, Aripiprazole, Donepezil Background Dementia with Lewy bodies (DLB) is recognized as the second common type of progressive neurodegenerative dementia in elderly people following Alzheimer’s dementia (AD) [1, 2], with core features characterized by fluctuating cognitive impairments, recurrent visual hallucinations, the motor symptoms of parkinsonism and REM sleep behavior disorder [3]. Various neuropsychiatric symptoms such as hallucinations and delusions occur more frequently in DLB than in AD patients [4], and among delusions, delusional misidentifications including Capgras syndrome associated with visual hallucinations represent the most frequent disturbance [5, 6].
*Correspondence: hiroko‑[email protected] 1 Department of Neuropsychiatry, Kumamoto University Hospital, Kumamoto, Japan Full list of author information is available at the end of the article
Delusional parasitosis, which is characterized by a fixed and persistent belief of having a pathogenic infection despite objective evidence to the contrary, is more common in dermatology rather than psychiatry [7]. It presents the distinction between primary and secondary delusional parasitosis; the former cannot be explained by any other condition, the latter can result from psychiatric disorders, substances of abuse, medication, and general medical conditions including organic brain disease such as dementia [8]. Here, we report the case of a DLB patient with delusional parasitosis.
Case presentation The patient was an 89-year-old woman. She had educational background with high school graduation. She had no medical history except for hypertension, and no family history of neuropsychiatric illness. She had helped for her son’s home business; however, she gr
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