Dementia With Lewy Bodies

A person who alternates between striking alertness and marked inattention, sees detailed people or animals who are not present, acts out dreams, and develops a slow rigid gait is showing a recognisable Lewy body pattern—not simply nonspecific memory loss. Dementia with Lewy bodies (DLB) is a progressive neurodegenerative dementia. Its bedside significance is twofold: the diagnosis depends on a characteristic combination of cognitive, perceptual, sleep and motor findings, and the person may deteriorate dramatically after exposure to dopamine-blocking medications. The nurse’s first safety question is therefore often, “Could this be DLB, and has a dopamine-blocking drug been ordered?”