Normal Pressure Hydrocephalus
Billy Joel could really change the entire trajectory of the condition - Amanda Garzón, Hydrocephalus Association
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image by: DrAsif Iqbal
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Normal Pressure Hydrocephalus (NPH) - a potentially reversible cause of cognitive decline
The classical triad characteristics of the NPH often quoted among neurologists can be summed as “the three W’s - wet, wacky, and wobbly.” Meaning: urinary incontinence, cognitive changes, and gait difficulties define the condition. However, these findings are notoriously nonspecific in the age group of patients typically presenting to neurologists with cognitive concerns, so progress for a universal set of criteria has been slow. As of right now, there are at least two sets of criteria; one is international, and one is Japanese...Resources
A New Treatment for Normal Pressure Hydrocephalus?
Normal pressure hydrocephalus (NPH)—a rare condition that causes cognitive and physical symptoms—has traditionally been treated with surgery that involves drilling holes in the skull. Surgeons then implant a shunt device and a long tube that snakes to the abdomen, where excess cerebrospinal fluid (CSF) is drained. Now, a Yale Medicine neurosurgeon is using a minimally invasive technique to treat this condition...
The Difficulties of Diagnosing Normal Pressure Hydrocephalus
What makes the diagnosis of NPH difficult is the fact that symptoms of NPH occur in other conditions that are common in an aging population, such as Parkinson’s disease (PD), osteoarthritis, and Alzheimer’s disease (AD). NPH-like symptoms can occur in Alzheimer’s, vascular dementia and Parkinson disease or NPH may be a co-morbidity with AD or PD. In NPH, not all of the symptoms arise at the same time.
Billy Joel cancels tour after being diagnosed with brain disorder normal pressure hydrocephalus
Normal pressure hydrocephalus is a condition in which excess cerebrospinal fluid accumulates in the brain’s ventricles, leading to difficulty walking, problems with thinking and reasoning and loss of bladder control. It primarily affects people in their 60s and 70s and is often misdiagnosed as Alzheimer’s disease or Parkinson’s disease, according to the Alzheimer’s Association.
Billy Joel cancels tour dates after diagnosis. What to know about the brain condition
"There's very few things in medicine where we can reverse symptoms or improve symptoms, and this is a disease where that's possible," he says. "So, it's a shame if it's missed — and it often is, for months or years, until the correct diagnosis is arrived at."
Billy Joel has excess fluid in his brain – a neurologist explains what happens when this protective liquid gets out of balance
Despite its importance, problems related to CSF often go unnoticed until something goes wrong.
Billy Joel Has Normal Pressure Hydrocephalus. What Is It?
The singer canceled his upcoming concerts because of the brain disorder. Here’s what to know about the symptoms, prognosis and treatment.
Normal Pressure Hydrocephalus: Diagnosis and Treatment
Normal pressure hydrocephalus (NPH) is a syndrome of gait dysfunction and enlarged cerebral ventricles in the absence of another cause. It is frequently accompanied by frontal and subcortical cognitive deficits and bladder detrusor overactivity. NPH is rare relative to other potential causes of these symptoms in the elderly, but timely diagnosis can lead to reversal of symptoms through ventricular shunting.
Understanding Normal Pressure Hydrocephalus Treatment: A Guide
Normal pressure hydrocephalus (NPH) is a neurological disorder that predominantly affects adults, particularly those over the age of 60. This condition is characterized by an abnormal accumulation of cerebrospinal fluid (CSF) in the brain’s ventricles, leading to increased pressure that can damage brain tissues. Despite the name, “normal pressure” refers to the fact that CSF pressure often remains within normal ranges when measured, yet the fluid buildup still causes significant issues.
Normal Pressure Hydrocephalus (NPH) - a potentially reversible cause of cognitive decline
Normal pressure hydrocephalus has a large prevalence. For example, in a US population-based study of a 2 in 1000 for those younger than 79 years, and up to almost 6 in 100 for those age 80 and above1. It’s also a controversial diagnosis among neurologists, since agreed-upon universal diagnostic criteria are difficult to come by, with diagnostic methods themselves varying from clinic to clinic. However, it’s worth addressing, since it represents a potentially reversible cause of dementia in some patients.
Hydrocephalus Association
What makes the diagnosis of normal pressure hydrocephalus (NPH) difficult is the fact that normal pressure hydrocephalus symptoms occur in other conditions that are common in an aging population, such as Parkinson’s disease (PD), osteoarthritis, peripheral neuropathy, and Alzheimer’s disease (AD).
Dr. Mark McLaughlin
Billy Joel’s decision to publicly share his diagnosis shines a light on a condition that is frequently underrecognized. When a beloved public figure faces a medical challenge, it often encourages people to seek out information and ask questions—especially if they or someone they love may be experiencing similar symptoms. Normal Pressure Hydrocephalus is a reminder that not all cognitive decline or balance issues in older adults are inevitable or untreatable. With increased awareness and timely evaluation, many patients can regain independence and improve their quality of life.
BrainFacts.org
Normal pressure hydrocephalus (NPH) is an abnormal buildup of cerebrospinal fluid (CSF) in the brain's ventricles, or cavities. It occurs if the normal flow of CSF throughout the brain and spinal cord is blocked in some way. This causes the ventricles to enlarge, putting pressure on the brain. Normal pressure hydrocephalus can occur in people of any age, but it is most common in the elderly. It may result from a subarachnoid hemorrhage, head trauma, infection, tumor, or complications of surgery. However, many people develop NPH even when none of these factors are present. In these cases the cause of the disorder is unknown.
Cureus
NPH can be idiopathic, where there is no identifiable etiology, or secondary. Secondary causes of NPH include subarachnoid hemorrhage, infection, head trauma, or tumor. The estimated incidence is 5.5 per 100,000. The prevalence is estimated to be 0.41-2.94% throughout five different studies on the prevalence of idiopathic NPH in elderly patients, from different countries.
International Parkinson and Movement Disorder Society
Although recently the entity of normal pressure hydrocephalus has been questioned, in everyday clinical practice it is evident that normal pressure hydrocephalus really exists. However, it is important to make a distinction between secondary cases (e.g. appearing after meningitis, subarachnoid hemorrhage or trauma) and “idiopathic” cases. Also, as the CSF pressure dynamics are abnormal (CSF pressure diagram during the day-night cycle), the term “chronic hydrocephalus of the elderly” which was proposed about 20 years ago could be a more accurate term.
StatPearls
Normal pressure hydrocephalus characteristically presents with progressive gait impairment, cognitive deficits, and urinary urgency and/or incontinence.
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