A case of back pain with a diagnosis of dementia with Lewy bodies (DLB)

Abstract

Intractable pain in elderly patients may occasionally be a symptom of dementia and requires prompt attention because dementia may significantly affect the treatment plan. We describe an elderly woman with back pain concomitant with mild parkinsonism, hallucinations, and severe depression in whom this clinical presentation led to the diagnosis of dementia with Lewy bodies (DLB). We initiated medical therapy for DLB, reduced analgesic agent administration to avoid worsening of cognitive impairment and established a social support system for her declining life functions. Despite its multiple symptoms, diagnosis of DLB is challenging and more difficult than the diagnosis of other types of dementia, such as Alzheimer's disease because patients with DLB often show lesser and occasionally no memory deficits. Clinicians should have sufficient knowledge of dementia and perform the necessary tests for cognitive function evaluation.