Brainstem-type Lewy body disease presenting with progressive autonomic failure and lethargy

Nozomi Hishikawa, Yoshio Hashizume, Masaaki Hirayama, Kazuhiro Imamura, Yukihiko Washimi, Yasuo Koike, Chiyuki Mabuchi, Mari Yoshida, Gen Sobue

Research output: Contribution to journalArticlepeer-review

30 Citations (Scopus)


The authors report an autopsy case characterized by progressive lethargy and autonomic failure with a distinctive pattern of occurrence of Lewy bodies. Autonomic dysfunction such as sleep apnea, orthostatic hypotension, dysuria, and hypohidrosis predominated with lethargy, whereas parkinsonism was not apparent. Numerous Lewy bodies were widely evident microscopically in brainstem nuclei and the intermediolateral cell columns of the spinal cord, as well as in the sympathetic ganglia, but were rare or absent in the cerebral cortex and other supratentorial structures. Marked neuronal loss was seen in the locus ceruleus, raphe nuclei, dorsal vagal nuclei, and intermediolateral cell columns, but neurons in the substantia nigra, other brain regions, and sympathetic ganglia appeared undiminished. This case represents a specific clinicopathologic form of Lewy body disease occurring predominantly in the brainstem, spinal cord, and sympathetic ganglia.

Original languageEnglish
Pages (from-to)139-143
Number of pages5
JournalClinical Autonomic Research
Issue number3
Publication statusPublished - 2000
Externally publishedYes


  • Lethargy
  • Lewy body
  • Parkinson disease
  • Progressive autonomic failure
  • Sleep apnea

ASJC Scopus subject areas

  • Endocrine and Autonomic Systems
  • Clinical Neurology


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