A face in the hedge: Dementia with Lewy bodies

Many patients will affirm seeing clouds shaped like animals or other similar phenomena, which is why confirming pareidolia (seeing meaningful images in meaningless visual stimuli) is such a tricky symptom in dementia with Lewy bodies (DLB). While it may not be exclusive to DLB, placing such symptoms in the context of "the company it keeps" is a key method to narrowing down the diagnosis. The Editors' Choice paper for the February 2026 issue of Practical Neurology is a practical guide to the clinical diagnosis and management of DLB. Authors Dr. Sarah Fullam¹ ² and Dr. Seán O'Dowd¹ ³ join PN podcast editor Dr. Amy Ross Russell to discuss their work. They describe the importance of the initial examination, from the patient's gait to difficulties in word retrieval. They also touch on challenges in the use of biomarkers, which drugs may be helpful, and how to advise patients and their carers. Read the paper: Dementia with Lewy bodies: a practical guide to clinical diagnosis and management Special thanks to The Podcast Studios Dublin for their assistance with the recording of this episode. (1) Tallaght Institute of Memory and Cognition, Tallaght University Hospital, Dublin, Ireland (2) Trinity College Dublin School of Medicine, Dublin, Ireland (3) Trinity College Dublin Academic Unit of Neurology, Dublin, Ireland Please subscribe to the Practical Neurology podcast on your favourite platform to get the latest episodes. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/3vVPClm) or Spotify (https://spoti.fi/4baxjsQ). We'd love to hear your feedback on social media - @PracticalNeurol. This episode was hosted by PN's podcast editor Dr. Amy Ross Russell. Production by Amy Ross Russell and  Brian O'Toole. Editing by Brian O'Toole. Thank you for listening.