Lord Janner is expected to appear in court next week after the chief magistrate ruled that he was fit enough to attend despite suffering severe dementia.
The peer is expected to be accused of a string of historic child sex abuse charges at Westminster Magistrates Court next Friday, August 14.
Chief Magistrate Howard Riddle ruled today that the 87-year-old former Board of Deputies president should appear in person, even if he could not understand proceedings or respond to questions.
The ex-MP was not in court to hear more than an hour of legal argument over the severity of his condition.
Lawyers will confirm on Tuesday whether arrangements have been made to bring Lord Janner to the court three days later.
He is likely to be charged with more than 20 counts relating to allegations of historic child sex abuse dating back to the 1960s, 1970s and 1980s.
Evidence was given by two expert dementia consultants as part of Lord Janner's defence case.
The court was told he was suffering from a severe form of dementia. Dr James Warner, a consultant psychologist had examined him on July 16 and found the peer's condition to be "worsening".
Dr Warner told the court that Lord Janner was "significantly more impaired" than when other doctors had previously examined him.
"Such is the severity of his dementia he would not be able to understand he was in court," the doctor said.
"He would not be able to comprehend virtually anything said to him or about him in court. He would not be able to respond meaningfully."
The court heard that Lord Janner had become distressed during a second examination, conducted by neuro-psychiatrist Norman Poole at the peer's home on July 28. He had paced the room, reacted angrily and eventually left.
But when he returned to the room 10 minutes later he had no recollection of the previous incident or of Dr Poole's examination.
The court heard such "catastrophic reaction" was common in patients suffering severe dementia.
Judge Riddle said: "There is no doubt he suffers from severe dementia. I accept he could not understand these proceedings and could not contribute in any meaningful way, perhaps not to even be identified.
"These are formal proceedings that are essential to the process. If Lord Janner is not fit to attend court then either the process ends or proceeds by a different route."
He made clear that appearing in court would have "no long-term effect" on the peer's health, adding that the court could work to minimise distress and to accommodate his needs.
"I'm satisfied that as far as being in court is concerned, the medical view is respectable. It will not do him any good - distressing as it may be for all of us."
His lawyer, Andrew Smith QC, said it was not possible to bring the peer to court within 24 hours due to the necessity to make special arrangements for his care.
Judge Riddle questioned whether it would be possible for the court to sit at Lord Janner's home and said it was possible an "imaginative approach" could be taken in what he said was an unprecedented case.
Clare Montgomery QC, prosecuting, said: "We accept he has severe dementia. He would be unable to understand or contribute to any part of the court process.
"There are significant adjustments that can be made to minimise the stress to him."
At next Friday's hearing the court is likely to advise the case be moved to a crown court, which would then decide whether Lord Janner was fit enough to stand trial, or whether a "trial of the facts" should take place.
The court was told the peer had moved to a new home around three months ago after his illness caused him to wander off.
He is now receiving extensive round-the-clock help from a team of carers.
Lord Janner's family has said he is "entirely innocent", and the peer denies any wrongdoing.