LBD- Clinical; PSP- Pathological

Curiously there were two brain donation cases I was involved in this year where the clinical DX was Lewy Body Dementia but the pathological diagnosis was PSP (with nary a Lewy body to be found).

Actually, one case was PSP + AgD (similar to Ed’s wife Rose), and the other was AD + PSP.

Neither of these patients had hallucinations, which are not required for LBD but you have to have either hallucinations or fluctuating cognition.

In the PSP + AgD case, I know the diagnosing neurologist well and am very surprised. Her reply: “humbling.”

Of course this made no difference for the treatment but always leaves people reeling in terms of expectations.