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A 67-year-old man is evaluated for several months of visual hallucinations that tend to occur at night or when he is short on sleep. He frequently falls asleep in the daytime. Two years ago, he had an episode of delirium and visual hallucinations after taking meclizine for vestibular neuronitis. He recovered 2 weeks after the meclizine therapy was discontinued. Neurologic examination reveals impairment of recent memory and attention, mild rigidity and resting tremor in the left arm, and a shuffling gait without postural instability.

Which of the following treatments is most appropriate in this patient?

A Donepezil
B Pergolide
C Carbidopa-levodopa
D Haloperidol
E Risperidone


shuffling gait.........parkinsonism.......CC


Yes C


This guy has visual hallucinations, this is not Parkinson

It's lewy body dementia

He needs Alzheimer drugs for that, going with A.


yes this is lewy body recurrent visual hallucinations+ parkinsonism +_ delirium

rx= donepezil.


You guys fell for the trap ("shuffling gait"...). Delirium with memory issues... like the above posters stated, it's obviously Lewybody dementia... donepezil is the treatment of choice


yes, lewy body dementia---> treat with donepezil, rivastigmine, galantamine

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