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Dementia with Lewy bodies
Other Resources UpToDate PubMed

Dementia with Lewy bodies

Contributors: Jamie Adams MD, Richard L. Barbano MD, PhD
Other Resources UpToDate PubMed


Dementia with Lewy bodies is a neurodegenerative disorder resulting in progressive cognitive decline and parkinsonism. Cognitive impairment occurs before or within 1 year of parkinsonism. The disease is age-related, with variable age of onset often between age 50 and 85. It is more common in men.

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

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Parkinson disease
  • Progressive supranuclear palsy
  • Corticobasal syndrome
  • Frontotemporal lobar degeneration
  • Alzheimer disease
  • Dementia and/or Parkinsonism
  • Multiple system atrophy
  • Normal pressure hydrocephalus
  • Creutzfeldt-Jakob disease
  • Paraneoplastic encephalopathy
  • Huntington disease
  • Parkinsonism
  • Neurodegeneration with brain iron accumulation
  • Whipple disease
  • Wilson disease
  • Neuroacanthocytosis
  • Tertiary syphilis
  • Vitamin B12 deficiency
  • Human immunodeficiency virus disease / Acquired immune deficiency syndrome dementia
  • Wernicke-Korsakoff syndrome

Best Tests

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Last Reviewed:02/05/2020
Last Updated:09/17/2020
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Dementia with Lewy bodies
A medical illustration showing key findings of Dementia with Lewy bodies : Gait disturbance, Depressed mood, Drowsiness, Cognitive decline, Visual hallucination
Copyright © 2024 VisualDx®. All rights reserved.