Dementia with Lewy bodies
Core clinical features include dementia, parkinsonism (bradykinesia, rigidity, tremor), fluctuating levels of alertness and cognition, visual hallucinations, and rapid eye movement (REM) sleep behavior disorder (dream enactment).
Additional features include frequent falls, orthostatic hypotension, constipation, urinary incontinence, neuroleptic sensitivity, myoclonus, depression, anxiety, apathy, systematized delusions, hypersomnia, and hyposmia.
Lack of response to levodopa is common; sustained dramatic positive response to levodopa should bring the diagnosis into question. Prognosis is poor, and most patients are significantly disabled within 5 years of diagnosis and die within 10 years of diagnosis.
Patients with this disorder may have an increased risk of various general medical conditions.
G31.83 – Dementia with Lewy bodies
80098002 – Diffuse Lewy body disease
Differential Diagnosis & Pitfalls
- Parkinson disease
- Progressive supranuclear palsy
- Corticobasal syndrome
- Frontotemporal dementia
- Alzheimer disease
- Vascular dementia and/or parkinsonism
- Multiple system atrophy
- Normal pressure hydrocephalus
- Creutzfeldt-Jakob disease
- Paraneoplastic encephalopathy
- Huntington disease
- Drug-induced parkinsonism
- Neurodegeneration with brain iron accumulation
- Whipple disease
- Wilson disease
- Vitamin B12 deficiency
- HIV / AIDS dementia
- Wernicke-Korsakoff syndrome