skip to main content

Dementia with Lewy Bodies — SCE Neurology MCQ

Instant feedback + full explanation. One question, done properly.

HardNeurodegenerative DiseaseDementia with Lewy BodiesSCE Neurology

A 68-year-old man presents with fluctuating cognition, detailed visual hallucinations of animals, and parkinsonism (bradykinesia and rigidity) that developed after the cognitive symptoms. He also has REM sleep behaviour disorder. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Dementia with Lewy bodies presenting before established parkinsonism

The best answer is “Dementia with Lewy bodies presenting before established parkinsonism”. Parkinsonian syndromes are distinguished by tempo, symmetry, eye movements, falls, autonomic and cognitive features; treatment is individualised to motor and neuropsychiatric burden. The alternatives “Parkinson disease dementia with motor symptoms established first”, “Alzheimer disease with later extrapyramidal adverse effects”, “Frontotemporal dementia with early behavioural disinhibition”, “Progressive supranuclear palsy with early vertical-gaze limitation” are clinically adjacent possibilities, but they do not match the defining chronology, localisation, physiology, investigation result or UK management sequence in this stem.

Reference: NICE NG71 Parkinson disease recommendations: https://www.nice.org.uk/guidance/ng71/chapter/Recommendations