An autopsied case of dementia with Lewy bodies with supranuclear gaze palsy

Hanae Nakashima, Seishi Terada, Hideki Ishizu, Yasuyuki Tanabe, Osamu Yokota, Takeshi Ishihara, Hiroshi Takata, Yuetsu Ihara, Toshiyuki Hayabara, Shigetoshi Kuroda

Research output: Contribution to journalArticlepeer-review

18 Citations (Scopus)


A 66-year-old man had suffered from a slow and steady decline in both physical and cognitive function for four years. He showed bradykinesia and small step gait with supranuclear vertical gaze palsy, especially upward gaze palsy. He was started on levodopa therapy but without response. A diagnosis of progressive supranuclear palsy was clinically suspected. He died at age 69. Pathologically, many α-synuclein positive inclusions were detected both in the brain stem and cerebral cortices, and the diagnosis of dementia with Lewy bodies was made. Scattered α-synuclein-positive inclusions and threads, which may be a pathological substrate for supranuclear gaze palsy, were identified in the rostal midbrain. From a review of five cases of dementia with Lewy bodies with supranuclear gaze palsy including this case, the absence of falls in the early stage of the disease, fluctuation of cognition, hallucination and vertical gaze palsy with a more severe defect in the upward direction distinguished dementia with Lewy bodies with vertical gaze palsy from progressive supranuclear palsy. In the differential diagnosis of parkinsonism with gaze palsy, clinicians should consider dementia with Lewy bodies with gaze palsy as well as progressive supranuclear palsy.

Original languageEnglish
Pages (from-to)533-537
Number of pages5
JournalNeurological Research
Issue number5
Publication statusPublished - Jul 1 2003


  • Dementia with Lewy bodies
  • Diffuse Lewy body disease
  • Progressive supranuclear palsy
  • Supranuclear gaze palsy

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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