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Diagnostic Accuracy of Dementia with Lewy Bodies
ArchNeurol 57:347-351, Hohl,U.,et al, 2000
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Article Abstract
The clinical diagnostic accuracy for DLB was 50%, with 5 of the 10 patients clinically presumed to have DLB confirmed at autopsy. Of the 5 misdiagnosed cases, 4 had AD and 1 had progressive supernuclear palsy. The misdiagnosed DLB cases who had pure AD had fewer hallucinations (25%) than those with Lewy body variant (63%) or diffuse Lewy body disease (100%) (P = .048); however, an equal amount of spontaneous (in the absence of neuroleptics) extrapyramidal signs was found. There were no differences among groups with regard to daily fluctuations in cognition of falls. Compared with the AD control group, the misdiagnosed DLB cases with pure AD showed significantly more spontaneous extrapyramidal signs (P = .02). The clinician's diagnos tic accuracy for DLB was poor. Early spontaneous extrapyramidal signs in AD were associated with false-positive clinical diagnoses of DLB. The distinction between DLB and AD may be improved by greater emphasis on hallucinations.
Related Tags
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Alzheimer's disease
dementia
hallucination
Lewy body disease,diffuse
misdiagnosis
movement disorder,extrapyramidal
neurologic disease,diagnoses of
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