This video shows a 67-yr-old patient with a two-year history of probable DLB (MMSE 21), with no previous neurological, psychiatric or medical history. Parkinsonian features appeared within the first year of cognitive impairment. Medication comprised a cholinesterase inhibitor and low dose co-careldopa.
Sequence 1: The caregiver's view of early symptoms (including visuospatial problems and REM-sleep behaviour disorder)
Sequence 2: The patient's description of his visual hallucinations, occurring usually at night, but not when falling asleep or waking up.
Sequence 3: Assessment of parkinsonian features, including reduced blink rate, significant hypomimia, monotonous speech, bradyphrenia, limb bradykinesia and reduced arm swing when walking.
Sequence 4: Illustrative components of the bed-side cognitive assessment. Memory function is relatively preserved (learning of three words and recall), but there are difficulties in visuo-construc-tional function (slowing and errors on the clock face including clock hands having the same length, and use of a "0" instead of "9").
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