What other physical exam findings are associated with dementia with Lewy bodies (DLB)?

Updated: Aug 08, 2019
  • Author: Howard A Crystal, MD; Chief Editor: Jasvinder Chawla, MD, MBA  more...
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Answer

An important observation during mental status testing is that the patient has periods of being alert, coherent, and oriented that alternate with periods during which the patient is confused and unresponsive to questions (despite the fact that the patient is awake). This fluctuation is a relatively specific feature of DLB.

Retrieval from memory may be relatively worse than memory storage. Patients may do relatively well with confrontation naming tests and poorly on tests of visuospatial skills (eg, drawing a clock, copying figures).

Patients may have some parkinsonian signs but usually not enough to meet the criteria for a diagnosis of Parkinson disease. Mild gait impairment is relatively frequent and should not be ascribed to old age or osteoarthritis. Resting tremor occurs less frequently than in Parkinson disease. Myoclonus may occur before severe dementia.

Orthostatic hypotension appears to be particularly common in patients with DLB, even when dementia is mild. [1]


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