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FIGURE 4–7. Dementia with Lewy bodies brain: section through the midbrain (left). Normal brain: section through the midbrain (right).Note the loss of the black neuromelanin pigment in the substantia nigra of the patient with dementia with Lewy bodies. This degeneration of the substantia nigra may cause extrapyramidal symptoms such as tremor, rigidity, and bradykinesia.

FIGURE 4–8. Dementia with Lewy bodies brain: pigmented neuron of the substantia nigra with several Lewy bodies (arrows).Lewy bodies are intraneuronal cytoplasmic inclusions with a clear halo. (Hematoxylin-eosin stain; original magnification x1,000.)

FIGURE 4–9. Dementia with Lewy bodies brain: pigmented neuron of the substantia nigra with numerous Lewy bodies.Many more Lewy bodies are apparent with this -synuclein immunostain than are seen in the routine preparation (Figure 4–8). (-Synuclein immunostain; original magnification x1,000.)

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