Pilar. I am enclosing the DX criteria used for LBD, maybe this will help you more, as to the Dr saying LBD and and Ad are treated the same I have to disagree, they are not the same. LBD presents different problems, Here is a web site for comparisons, just scroll down and you will see it.
The tests the Dr has order are good they will help rule other things out.
DIAGNOSTIC CRITERIA - Central and Core Features for clinical diagnosis
CENTRAL FEATURE OF LBD(must be present for diagnosis of LBD)
- Progressive dementia ? Impairment of *activities of daily living (cognitive impairment) *Activities of Daily Living (ADL) Personal care activities necessary for everyday living such as eating, bathing, grooming, dressing, mobility in home and toileting (continence).
Instrumental ADL - Activities related to independent living and include preparing meals, taking medication, managing money, getting to places beyond walking distance, doing laundry, shopping for groceries or personal items, performing light or heavy housework, and using a telephone.
CORE FEATURES OF LBD (PROBABLE LBD may be diagnosed with the presence of dementia PLUS TWO core features, OR one core feature and one suggestive feature).
- Fluctuating cognition or alertness are periods of time when cognition and arousal are near normal in contrast to other periods of more marked confusion or hypersomnolence. (cognitive impairment or unknown combination of neurochemical alterations and possibly one or more sleep disorders)
- Recurrent complex (well defined) visual hallucinations. Profound distortion in a person's perception of reality, typically accompanied by a powerful sense of reality. (neurophsychiatric feature)
- Parkinsonism (motor dysfunction)
SUGGESTIVE FEATURES OF LBD (Possible LBD may be diagnosed with dementia plus either one core or one suggestive feature)
- Severe sensitivity to neuroleptics (anti-psychotic drugs) occurs in up to 50% of LBD patients. These medications can worsen the Parkinsonism and/or decrease the cognition and/or increase the hallucinations. Neuroleptic Malignancy Syndrome, a life-threatening illness, has been reported in persons with Lewy Body Dementia.
- REM (rapid eye movement) sleep behavior disorder (RBD), (sleep disorder)
CATEGORIZING LBD SYMPTOMS
Five categories of clinical features that may be present in LBD
Motor Dysfunction (Parkinsonism)
Autonomic Nervous System (ANS) dysfunction
1. Cognitive Impairment:
o Executive dysfunction; difficulty understanding complex or multi-step instructions
o Episodes of disorganized speech
o Disoriented about the time or present location
o Bradyphrenia (slowness of mental processes)
o Visuospatial impairment; depth perception and object orientation; directional sense impairment and geographic disorientation (lost while driving, difficulty navigating in shopping center or own homes)
o Verbal blocking; looses train of thought in the middle of a sentence or conversation.
o Short-term memory; decline in ?active? memory (15-30 seconds)
o Misidentification errors involving people; failure to recognize spouse or children
2. Neurophsychiatric Features:
o Hallucinations: visual (sight) auditory (sound), tactile (touch) and olfactory (smell).
Sensory perception experienced in the absence of an external stimulus.
o Systematized delusions; Capgras syndrome (delusions): belief that a known person has been replaced by an identical looking imposter; non-recognition of mirror image
o Illusions; misperception of an external stimulus; (perceiving chairs, lamps, or mailboxes as people or animals)
o Anxiety, depression
o Anger, sadness
o Agitation, aggressive behavior
o Apathy (lack of emotion, motivation, or enthusiasm)
3. Motor Dysfunction (Parkinsonism):
o Tremors (often postural and symmetric, resting tremor less common)
o Rigidity (stiffness of the limbs and trunk; resistance to movement)
o Facial impassivity
o Bradykinesia (slowing down and loss of spontaneous and automatic movement; ability to start and continue movements)
o Shuffling gait; Stooped posture
o Repeated falls from postural instability or impaired balance and coordination
o Difficulty with fine motor skills (tying shoes and buttoning)
o Dysphagia (swallowing difficulties)
4. Sleep Disorders:
o REM (rapid eye movement) sleep behavior disorder (RBD), including acting out dreams, yelling, flailing limbs, nighttime insomnia, daytime drowsiness
o Restless Leg Syndrome (RLS)
o Excessive daytime somnolence (EDS) (an inability to stay awake when sedentary)
5. Autonomic Nervous System (ANS) dysfunction:
o Orthostatic hypotension, (low blood pressure upon standing) dizziness, light-headedness
o Transient, unexplained loss of consciousness, syncope (fainting), vertigo, falls
o Weakness, fatigue
o Decreased sweating and heat intolerance
o Urinary dysfunction (frequency, urgency and incontinence)
o Constipation, diarrhea, and impotence
o Coat-hanger pain (head and neck)
o Weak or hoarse voice