An 80-year-old has fluctuating cognition, well-formed visual hallucinations of children and mild parkinsonism. He becomes severely rigid and unresponsive after haloperidol. Which diagnosis explains this?
Answer and explanation
Correct answer: A. Dementia with Lewy bodies and neuroleptic sensitivity
- Step 1: Visual hallucinations, fluctuating attention and parkinsonism are core features of Lewy body dementia. Step 2. These patients have severe adverse reactions to antipsychotics, so they are avoided, and cholinesterase inhibitors are used instead. Answer: Dementia with Lewy bodies and neuroleptic sensitivity. Why not the others: Alzheimer's disease does not typically cause this reaction. Frontotemporal dementia presents with behavioural change. Vascular dementia has a stepwise course.
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