Major Neurocognitive Disorder Due To Lewy Body Disease

Major neurocognitive disorder due to Lewy body disease is characterized by progressive cognitive decline accompanied by fluctuating attention, visual hallucinations, and parkinsonism. Etiology involves abnormal accumulation of alpha-synuclein-containing Lewy bodies in cortical and subcortical neurons. Clinically, patients present with cognitive fluctuations, REM sleep behavior disorder, visual hallucinations, and parkinsonian motor features. Diagnosis is clinical, supported by neuroimaging and exclusion of other dementias, particularly Alzheimer disease. Management includes cholinesterase inhibitors for cognitive symptoms, cautious use of dopaminergic agents for motor symptoms, and behavioral interventions to manage hallucinations and agitation.