Early diagnosis of DLB

Katsuyoshi Mizukami

Sports and Health Promotion, Graduate School of Comprehensive Human Sciences, University of Tsukuba

While it is not difficult to make a diagnosis of dementia with Lewy bodies (DLB) for typical cases, those presenting with psychotic symptoms and physical symptoms as the initial symptoms make diagnosis quite challenging. Clinical conditions, such as REM sleep behavior disorder, autonomic dysfunctions, depression, anomia, severe neuroleptic sensitivity, and a past history of delirium, are useful in making a diagnosis of DLB, since these often occur at the prodromal stage. Low uptake in the occipital lobes on SPECT and low uptake MIBG myocardial scintigraphy are observed in the early stages of DLB. Decreased ventilatory response to hypercapnia is also observed at the prodromal stage of DLB. This means that patients with DLB have both cerebrovascular and respiratory problems at an early or prodromal stage of DLB. Considering the possibility of DLB and focusing on the presentation of the above-mentioned clinical features are important in diagnostic accuracy for DLB.

Address correspondence to Dr. Katsuyoshi Mizukami, Sports and Health Promotion, Graduate School of Comprehensive Human Sciences, University of Tsukuba(Tokyo Bunkyo School Building, 3-29-1 Otsuka, Bunkyo-ku, Tokyo 112-0012, Japan)