Parkinsonian features of eight pathologically diagnosed cases of diffuse lewy body disease

Elan D. Louis, James E. Goldman, James M. Powers, Stanley Fahn

Research output: Contribution to journalArticlepeer-review

56 Scopus citations


Premortem diagnosis of diffuse Lewy body disease (DLBD) is difficult, and knowledge of the parkinsonian features of DLBD might facilitate the diagnosis. In this study, we compared the parkinsonian syndrome of DLBD and Parkinson's disease (PD). We retrospectively reviewed the charts of Columbia‐Presbyterian Medical Center (CPMC) Brain Bank cases (1989–1993) with pathologically diagnosed DLBD or PD, and the literature on the parkinsonian features in DLBD patients presenting with parkinsonism. Parkinsonism accompanied or preceded cognitive/psychiatric changes in most CPMC cases (DLBD 100%, PD 88%). DLBD had an earlier mean age of onset than PD did (57 versus 64 years), a similar male: female ratio (1.7:1 versus 1.9:1), and similar mean disease duration (12–13 years). Cognitive/psychiatric changes were less frequent in PD than in DLBD (65 versus 100%) (p = 0.025). Rest tremor was specifically mentioned in 29% of DLBD versus 56% of PD (p = 0.10). Bradykinesia was less common in PD (56% versus 86%) (p = 0.05). All those with PD responded to L‐Dopa, as did all those with DLBD who received L‐Dopa. In conclusion, there are subtle differences between PD and DLBD in age of onset, frequency of cognitive/psychiatric changes, bradykinesia, and rest tremor. However, even when taken together, these cannot be used to distinguish these entities.

Original languageEnglish (US)
Pages (from-to)188-194
Number of pages7
JournalMovement Disorders
Issue number2
StatePublished - Mar 1995
Externally publishedYes


  • Diffuse Lewy body disease
  • Parkinson's disease

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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