Living with Lewy body dementia means managing marked day-to-day fluctuation, visual hallucinations, and movement symptoms together. The single most important practical point is severe sensitivity to antipsychotic medication, which must be known by everyone prescribing. Carrying written information about the diagnosis and that sensitivity, and stating it at every new clinical encounter, is genuinely protective.
Living with Lewy body dementia means managing marked day-to-day fluctuation, visual hallucinations, and movement symptoms together. The single most important practical point is severe sensitivity to antipsychotic medication, which must be known by everyone prescribing. Carrying written information about the diagnosis and that sensitivity, and stating it at every new clinical encounter, is genuinely protective.
People with Lewy body dementia are frequently severely sensitive to antipsychotic medication, and reactions can be serious. Because hallucinations are a prominent feature, those drugs may be offered before the diagnosis is recognised, including in emergency departments or care settings by clinicians who do not know the diagnosis. Carrying written information about the diagnosis and this sensitivity, and stating it at every new clinical encounter, is a genuinely protective measure rather than an excess of caution.
Alertness and confusion vary markedly over hours or days, with genuinely good periods in between. Families frequently describe the person as present some days and not others, and outsiders often misread this as not trying or as exaggeration. Clinicians can be misled too, because a good day at an appointment understates the difficulty. Keeping a brief written note of what the bad days look like, with dates, gives the clinical team something the consultation itself may not show.
Visual hallucinations are typically well formed and detailed, often of people or animals, and are frequently not distressing, in which case they may not need treating at all. Responding calmly without arguing about whether they are real generally works better than correction. Movement symptoms mean falls risk, so home safety and physical therapy matter. Acting out dreams during sleep can cause injury to either person, so bed safety is worth addressing practically.
Clinical Neurology Specialists has been physician-owned since 1998, when Leo Germin, M.D., FAANEM founded it. Five board-certified neurologists and four advanced practice providers see patients at the Las Vegas and Henderson offices, each with its own AANEM-accredited electrodiagnostic laboratory.
Clinical Neurology Specialists is an adult outpatient neurology practice for patients 18 and older. The practice performs no surgery and operates no imaging suite, infusion suite or interventional pain programme, and provides no emergency or inpatient care.
Physician-reviewed. Reviewed by the physicians of Clinical Neurology Specialists — board-certified neurologists, AANEM-accredited electrodiagnostic laboratories, physician-owned since 1998. Reviewed 1 August 2026. This article is general education for adults 18 and older and is not a substitute for a consultation.
Sources and further reading: MedlinePlus: Alzheimer disease; National Institute on Aging; MedlinePlus: Parkinson's disease.
Adults 18 and older, at the Las Vegas and Henderson offices. Call 702-804-1212 or request an appointment online.