How is dementia with Lewy bodies (DLB) diagnosed?

Updated: Sep 24, 2018
  • Author: Stephen M Bloomfield, MD; Chief Editor: Selim R Benbadis, MD  more...
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Answer

Answer

The Consortium on Dementia with Lewy bodies (DLB) proposed consensus clinical and pathologic criteria for diagnosis of DLB (ie, DLB criteria) in 1996. [43] Three major clinical criteria were described: (1) visual hallucinations, (2) fluctuating cognition, and (3) spontaneous motor features of parkinsonism. One of the 3 criteria is required to diagnose possible DLB, and 2 of the 3 are needed for probable DLB. The minor criteria include repeated falls, syncope, transient loss of consciousness, neuroleptic sensitivity, systematized delusions, and hallucinations in other modalities (auditory, olfactory, tactile).

Verghese et al tested the validity of these criteria. If DLB criteria were applied to the 18 patients with DLB and the 76 patients with non-Lewy body dementias in their sample, the definition for possible DLB had excellent sensitivity (89%) but poor specificity (28%), and the criteria for probable DLB had moderate sensitivity (61%) and good specificity (84%). [44]


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