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Clinical features and diagnosis of dementia with Lewy bodies

Author
Martin R Farlow, MD
Section Editor
Steven T DeKosky, MD, FAAN, FACP, FANA
Deputy Editor
April F Eichler, MD, MPH

INTRODUCTION

Dementia with Lewy bodies (DLB) is increasingly recognized clinically as the second most common type of degenerative dementia after Alzheimer disease (AD). In addition to dementia, distinctive clinical features include: visual hallucinations, parkinsonism, cognitive fluctuations, dysautonomia, sleep disorders, and neuroleptic sensitivity.

First described in the 1960s, DLB has a varied clinical presentation that shares features with other degenerative dementias. It was often overlooked pathologically because of the difficulty in identifying cortical Lewy bodies. With the advent of immunohistochemical stains for some of the constituents of Lewy bodies, the prevalence of this disorder began to be recognized. However, challenges remain in defining this as a distinct entity differentiable from other degenerative dementias.

There is some clinical imperative to diagnose DLB, as optimal treatment choices - for best efficacy and limitation of significant side effects - are specific to DLB. However, DLB continues to be under recognized, and the clinical diagnostic criteria continue to be refined to improve specificity and sensitivity.

This topic will describe the clinical and radiologic features and diagnosis of dementia with Lewy bodies. The epidemiology, neuropathology, pathogenesis, prognosis, and treatment of this disorder are discussed separately. (See "Epidemiology, pathology, and pathogenesis of dementia with Lewy bodies" and "Prognosis and treatment of dementia with Lewy bodies".)

Other dementia syndromes are discussed separately. (See "Cognitive impairment and dementia in Parkinson disease" and "Etiology, clinical manifestations, and diagnosis of vascular dementia" and "Clinical features and diagnosis of Alzheimer disease" and "Frontotemporal dementia: Clinical features and diagnosis".)

                           

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Literature review current through: Nov 2016. | This topic last updated: Mon Apr 04 00:00:00 GMT 2016.
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