Older Bipolar Patient with Treatment-Refractory Neuropsychiatric Symptoms Due to Lewy Body Dementia: Role of Neuroimaging

Author(s): Jennifer M Lyman, Brett Y Lu, Rodel Maulit, Michiko Kimura Bruno

When treatment-refractory neuropsychiatric symptoms develop in older persons with chronic mental illness, differential diagnoses, treatment and medical workup become even more demanding. The differential diagnoses are vast and treatment limited due to increased susceptibility to neuroleptic-induced parkinsonism. In this case of an older bipolar patient with difficult-to-manage mania and catatonia, the use of neuroimaging allowed us to establish a clear diagnosis of Lewy Body dementia and modify her pharmacotherapy accordingly and effectively. Familiarizing ourselves with the utility of the dopamine transporter scan (DaT) provides the psychiatrist another tool within their diagnostic toolbox.