| How to diagnose dementia with Lewy bodies: state of the art. | |
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MedLine Citation:
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PMID: 16092075 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Dementia with Lewy bodies (DLB) is the second most common cause of neurodegenerative dementia in older people that has only been recognized in the past decade and that remains widely underdiagnosed. At postmortem examination, affected patients show numerous alpha-synuclein-positive Lewy bodies (LB) in many parts of the cerebral cortex, particularly neocortical and limbic areas in addition to the nigral LB degeneration characteristic of Parkinson's disease (PD). Clinical presentation, unlike PD, is with progressive cognitive decline with particular deficits of visuospatial ability as well as frontal executive function accompanied by usually only mildly to moderately severe parkinsonism, which is often akineto-rigid without the classical parkinsonian rest-tremor. Further accompanying features include spontaneous recurrent visual hallucinations and conspicuous fluctuations in alertness and cognitive performance. The two main differential diagnoses are Alzheimer's disease (AD) and Parkinson's disease dementia (PDD). To improve the differential diagnosis of DLB, consensus criteria have been developed that establish possible and probable levels of clinical diagnostic accuracy. Generally, their sensitivity is variable and low but their specificity is high. Current consensus is to restrict a diagnosis of DLB only to patients with parkinsonism who develop dementia within 12 months of the onset of motor symptoms. Using operationalized criteria, DLB can be diagnosed clinically with an accuracy similar to that achieved for AD or PD. Ancillary investigations, particularly neuroimaging, can aid in differential diagnosis. We review the present state of the best practice in the clinical diagnosis of DLB. Future modifications of diagnostic criteria would ideally include the full range of clinical presentations that can be associated with LB disease. |
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Authors:
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Felix Geser; Gregor K Wenning; Werner Poewe; Ian McKeith |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Movement disorders : official journal of the Movement Disorder Society Volume: 20 Suppl 12 ISSN: 0885-3185 ISO Abbreviation: Mov. Disord. Publication Date: 2005 Aug |
Date Detail:
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Created Date: 2005-08-15 Completed Date: 2005-12-13 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8610688 Medline TA: Mov Disord Country: United States |
Other Details:
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Languages: eng Pagination: S11-20 Citation Subset: IM |
Copyright Information:
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Copyright 2005 Movement Disorder Society. |
Affiliation:
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Clinical Department of Neurology, Medical University Innsbruck, Austria. felix.geser@uibk.ac.at |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Accidental Falls
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statistics & numerical data Age Factors Aged Alzheimer Disease / diagnosis Brain / pathology Cerebral Cortex / metabolism Cognition Disorders / epidemiology Diagnosis, Differential Dysarthria / epidemiology Electromyography Hallucinations / epidemiology Humans Hypotension, Orthostatic / epidemiology Lewy Bodies / metabolism Lewy Body Disease / diagnosis*, epidemiology, metabolism Limbic System / metabolism Magnetic Resonance Imaging Parkinson Disease / diagnosis Substantia Nigra / metabolism Urinary Incontinence / epidemiology alpha-Synuclein / metabolism |
| Chemical | |
Reg. No./Substance:
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0/alpha-Synuclein |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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