Lewy body dementia is a progressive
neurodegenerative disease and is considered to be the second most common cause of
dementia in the elderly. Because of the complexity of clinical presentation, it is often misdiagnosed and mistaken for other
dementias, which may result in administering inappropriate
therapy, and thus worsening of the patient condition. We reviewed a case of a 71-year-old patient whose clinical presentation gradually occurred with complex
visual hallucinations, atypical extrapyramidal motor symptoms, fluctuating
cognitive impairments with delirious episodes, and oscillating
syncope. Depressive mood, impaired daily functioning and sensitivity to
antipsychotics were also noted. Extensive diagnostic workup was performed with neuropsychological testing and use of single-photon emission computerized tomography. Considering the clinical presentation and diagnostic procedures performed, the diagnosis of
Lewy body dementia was set and
pharmacotherapy was revised. We discuss the importance of taking overall clinical presentation and diagnostic treatment in consideration and applying appropriate
therapy to slow down the progression of the disease and exacerbation of the patient's psychological functions.