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MS Cognition – Processing Speed — SCE Neurology MCQ

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HardMultiple Sclerosis & CNS InflammationMS Cognition – Processing SpeedSCE Neurology

A man developed bradykinesia and rigidity in January 2024. Retrospective collateral history establishes functionally significant visuospatial dementia and recurrent formed hallucinations from September 2024. How should the syndrome be labelled using the operational one-year rule?

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Correct answer: B — Dementia with Lewy bodies because dementia began within one year of motor parkinsonism

Explanation lettering: C = shown as A · E = shown as B · A = shown as C · B = shown as E

E is correct. Dementia beginning before or within one year of parkinsonism is operationally classified as DLB; PDD requires established Parkinson disease for more than a year before dementia. A ignores the boundary. B reverses it and wrongly excludes hallucinations, a core DLB feature. C overlooks the typical early visuospatial profile. D is inconsistent because prominent early dementia and hallucinations do not define MSA.

Reference: DLB and Parkinson-disease dementia timing rule: https://pmc.ncbi.nlm.nih.gov/articles/PMC10272890/