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Dementia with Lewy bodies

Lookup NU author(s): Professor Ian McKeith


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Background Dementia with Lewy bodies (DLB) is a common dementia subtype that has only been recognised in the past decade and that remains widely underdiagnosed. Aims To review the pathological and clinical features of DLB, to consider methods of investigation and diagnosis, and to recommend safe and effective management strategies. Method A selective review was made of the key literature. Results Using operationalised criteria, DLB can be clinically diagnosed with an accuracy similar to that achieved for Alzheimer's disease or Parkinson's disease Underdetection is largely due to poor definition of the criterion of cognitive fluctuation. Ancillary investigations, particularly neuroimaging, can aid in differential diagnosis. Extreme caution in the use of neuroleptic medication is advised. Cholinesterase inhibitors may be particularly effective in DLB. Conclusions Clinicians should be aware of DLB as part of a spectrum of Lewy body disorders. Neuroleptic sensitivity reactions and good response to cholinergic therapies are important aspects of management. Declaration of interest None.

Publication metadata

Author(s): McKeith IG

Publication type: Article

Publication status: Published

Journal: British Journal of Psychiatry

Year: 2002

Volume: 180

Issue: 2

Pages: 144-147

ISSN (print): 0007-1250

ISSN (electronic): 1472-1465

Publisher: Royal College of Psychiatrists