Idiopathic clouding of consciousness—do the patients have cortical lewy body disease?

Abstract

Sixteen out of 58 patients assessed at a day hospital for probable dementia fulfilled the study definition for idiopathic clouding of consciousness. These patients were significantly more likely than other patients in the sample to have visual hallucinations, depression, extrapyramidal symptoms and to experience falls. They hence had the same symptom profile as patients described as having cortical Lewy body dementia, an observation supported by the fact that 14 of the 16 fulfilled McKeith's criteria for the aforementioned condition. Fifty per cent of the patients with idiopathic clouding of consciousness had a family history of Parkinson's disease. The implications of the findings are discussed.

Clinical lewy body dementia and the impact of vascular components

“…When we used these consensus criteria for clinical DLB it was possible on clinical grounds to identify a group of LBD patients restrospectively in a dementia project with a prospective design. The prevalence of LBD thus de®ned in this group, 24.7%, was very similar to earlier ®ndings using dierent sets of clinical criteria for dementia associated with Lewy bodies, 24% (Ballard et al, 1993) and 26% (Shergill et al, 1994). Based on this, we have analysed the clinical features in this LBD group and compared them to other clinically diagnosed dementia groups, mainly AD.…”

The characterisation and impact of ‘fluctuating’ cognition in dementia with Lewy bodies and Alzheimer's disease

“…The importance of FC is evident from anecdotal reports that indicate considerable changes in day to day functioning (McKeith et al, 1992;Byrne et al, 1989;Gibb et al, 1987;Yamamoto and Imai, 1988;Burkhardt et al, 1988;Crystal et al, 1990;Ballard et al, 1993;Ishikawa et al, 1997;Wagner and Bachman, 1996;Hely et al, 1996;Briel et al, 1999). Recent work supports the expert view that thesē uctuations in cognition relate closely to variability in attention and to impairments of consciousness (Walker et al, 2000a).…”

Neuropsychiatric aspects of dementia with lewy bodies

“…Neuropsychiatric symptoms including hallucinations, delusions, and depression are characteristic features of DLB, as are parkinsonism and cognitive fluctuations [1][2][3][4][5][6][7][8][9][10][11][12]13••, [14][15][16][17][18][19][20][21][22][23][24]. The reported rates, severity, and profile of the neuropsychiatric symptoms, however, have been inconsistent (Tables 1-3).…”