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Dementia with Lewy bodies — DGM MCQ

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HardDementiaDementia with Lewy bodiesDGM

An 80-year-old man has fluctuating confusion, vivid visual hallucinations and two falls. His wife says some days he is lucid, and on examination he has bradykinesia and rigidity. Memory loss started at the same time as the motor symptoms. What is the most likely diagnosis?

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Correct answer: C — Dementia with Lewy bodies

Cognitive fluctuation, recurrent visual hallucinations and spontaneous parkinsonism strongly suggest dementia with Lewy bodies. Alzheimer's disease can cause hallucinations late, but early hallucinations and parkinsonism point away from it. DLB is important because antipsychotic sensitivity can be severe.

Reference: NICE NG97