Health & wellness

Is it normal pressure hydrocephalus?

Normal pressure hydrocephalus, known as NPH, is a brain disorder that has three distinct symptoms, which usually come on gradually:

ªAn unsteady, almost penguin-like shuffle.

ª Loss of bladder control or frequent, sudden urges to urinate.

ªShort-term memory loss, an overall slowing of thought processes, difficulty paying attention, apathy, and change in personality and behavior.

Often a person with NPH may not have all three symptoms, but the unusual gait is typically the most common.

Diagnosis includes a brain scan that reveals enlarged ventricles, which are hollow, fluid-filled chambers of the brain. That is typically followed by a lumbar drain trial in which a physician inserts a needle and catheter into a patient’s lower back and slowly drains large amounts of spinal and brain fluid over several days.

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The patient’s ability to walk is measured before and during the lumbar trial to see if draining fluid improves the patient’s gait.

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If symptoms improve, specialists say it is a sign that a patient would likely benefit from surgery to implant a shunt in the brain to continuously drain excess fluid.

Studies about long-term results from treatment have mixed conclusions, but suggest that walking ability is the first and most likely symptom to improve in patients who receive a shunt. Incontinence and cognitive problems are slower to improve, sometimes taking months, and may not totally resolve.

SOURCES: Brigham and Women’s Hospital; Alzheimer’s Association.

Kay Lazar can be reached at klazar@globe.com. Follow her on Twitter @GlobeKayLazar.