Diagnosis

The Diagnosis of Dementia with Lewy Bodies (DLB)

To make the diagnosis of DLB, the doctor must be certain that it is dementia with a progressive loss of cognitive skills. Attention and sense of direction are often particularly affected.

For it to be DLB, two of the following symptoms must also be present:

• the course must be fluctuating (attention in particular),
• repeated visual or auditory hallucinations and
• spontaneous Parkinson's symptoms that are not medication-related.

The suspicion that it is DLB can further be supported if the person has had falls, sometimes due to brief bouts of dizziness.

The diagnosis is also supported if the person cannot tolerate the use of antipsychotic medication.

In addition, the person also often has a condition called "REM (rapid eye movement) Behaviour Sleep Disorder”. It occurs because the person, during their REM cycle (the dream cycle), lacking the natural paralysis of their muscles and thus "acting their dreams out" by flailing their arms and legs. Depression is often observed as well.

What makes the diagnosis of DLB less likely?

The diagnosis is less likely if the person has a blood clot in their brain which shows up either in the form of symptoms or during a brain scan. It is also less likely to be DLB if there are indications that the person has another disease that can explain the condition.

The Final Diagnosis

The final diagnosis is based on whether Lewy Bodies are found in the nerve cells in the cerebral cortex.