Introduction:
Dementia with Lewy Bodies (DLB) is the second most prevalent form of dementia in older adults, behind Alzheimer’s dementia.(1) The presence of parkinsonism, visual hallucinations, cognitive fluctuations, and Rapid Eye Movement (REM) sleep disturbances hallmarks dementia with Lewy bodies (DLB). (2) The Associated visual hallucinations and illusions exhibit a high level of complexity, are well-developed, and last over time.
The room tilt illusion (RTI) or Tortopsia often occurs in individuals with vestibular system disorders, resulting in a misalignment of visual representations in the brain. (3). In the extreme form, there is a complete 180º rotation of the environment, known as the ”upside-down” illusion.(3) The ”clock drawing test” may be used to determine the existence of Tortopsia.(4) Visuospatial dysfunction due to occipitotemporal hypoperfusion may contribute to a room tilt illusion and palinopsia in patients with DLB.(5) We also propose that early aggregation of Alpha Synucleins in the vestibular nucleus of the brainstem may explain the vestibular-visual mismatch and associated illusions along with early recurrent falls in the early phase of DLB.(6)
To our knowledge, this is the first report on room tilt illusion in DLB.