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Health Information Alzheimer's or Normal Pressure Hydrocephalus (NPH)
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Not All Memory Problems Are Alzheimer’s-Related

Currently there is little long-term hope for people with Alzheimer’s disease. But for a percentage whose diagnosis is wrong, there may even be a cure. Normal pressure hydrocephalus (NPH), a lesser-known condition with symptoms that look a lot like Alzheimer’s disease, has a solution. Of the estimated 750,000 Americans who have NPH, fewer than 20 percent are appropriately diagnosed and treated.

Here, Lorenzo F. Muñoz, MD, a neurosurgeon at Rush University Medical Center in Chicago, and Martin J. Gorbien, MD, a geriatrician at Rush, discuss NPH.

What is NPH?
Normal pressure hydrocephalus is an excessive buildup of fluid in the brain occurring most often in people over age 60.

What are the symptoms of NPH?
There are three classic symptoms of NPH:

  • Abnormal walk, which is often the first symptom to appear and almost always the most pronounced; it is typically a wide-based, slow, shuffling step that could lead to frequent falling.
  • Mild dementia, which includes short-term memory loss and difficulty dealing with simple routine tasks.
  • Urinary incontinence, which is often the last apparent symptom; someone with NPH may experience frequent urgency or a complete loss of bladder control.

“It’s important to keep in mind that only one or two of these symptoms may be present,” Gorbien cautions.

How is NPH diagnosed and treated?
The first step to diagnosing NPH is a magnetic resonance imaging (MRI) scan or a computerized tomography (CT) scan, along with a thorough clinical history (usually from a primary care physician) and neurological assessment (from a neurologist).

If NPH is still suspected after the initial physician consultations, Gorbien and Muñoz recommend an inpatient, three-day test in which a shunt is used to drain excess fluids. During the test, a multidisciplinary team, including a neurosurgeon, physical therapist, speech pathologist and neuropsychologist, determines whether symptoms adequately improved enough to indicate that a permanent shunt would be a viable long-term solution.

If you think you or a friend or relative might have NPH, call (888) 352-RUSH (7874) to schedule an appointment with a geriatrician or a neurologist.

 

Visit the RUSH Generations site to learn more about a free health and aging membership program for older adults and people who care for them.

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