Hallucinations in Dementia with Lewy bodies

Q: 78 years old male is admitted to the ICU with acute psychosis kind of symptoms. The patient has been previously diagnosed with dementia with Lewy bodies (DLB). Which is more common in DLB? - select one

A) Auditory hallucinations

B) Visual hallucinations

Answer: B

The three major core clinical features of DLB are:

• cognitive fluctuations
• visual hallucinations, and 
• parkinsonism

Rapid eye movement (REM) sleep behavior disorder is also described as an early sign of DLB. Genetic predisposition is highly associated.

#psychiatry

#neurology

#geriatrics

References:

1. Devenyi RA, Hamedani AG. Visual dysfunction in dementia with Lewy bodies. Curr Neurol Neurosci Rep. 2024 Aug;24(8):273-284. doi: 10.1007/s11910-024-01349-8. Epub 2024 Jun 22. PMID: 38907811; PMCID: PMC11258179.

2. Ballard C, McKeith I, Harrison R, O'Brien J, Thompson P, Lowery K, Perry R, Ince P. A detailed phenomenological comparison of complex visual hallucinations in dementia with Lewy bodies and Alzheimer's disease. Int Psychogeriatr. 1997 Dec;9(4):381-8. doi: 10.1017/s1041610297004523. PMID: 9549588.

3. Rampello L, Cerasa S, Alvano A, Buttà V, Raffaele R, Vecchio I, Cavallaro T, Cimino E, Incognito T, Nicoletti F. Dementia with Lewy bodies: a review. Arch Gerontol Geriatr. 2004 Jul-Aug;39(1):1-14. doi: 10.1016/j.archger.2003.11.003. PMID: 15158576.