What are the Signs of Normal Pressure Hydrocephalus (NPH)
Posted Jul 08 2009 9:55am
Previously, I wrote an article about Jimmy Nowells. Jimmy was diagnosed with Parkinson's and then Alzheimer's. After ten long years of misdiagnosis-- and thanks to his daughter--Jimmy was correctly diagnosed with Normal Pressure Hydrocephalus (NPH).
Normal pressure hydrocephalus is usually characterized by a three symptoms:
complaints of gait disturbance (difficulty walking)
and impaired bladdercontrol.
These symptoms may not occur all at the same time. Sometimes only one or two of the symptoms are present.
Gait disturbances range in severity from mild imbalance to the inability to stand or walk at all. Gait is often wide based, short-stepped, slow and shuffling.
People with NPH may have trouble picking up their feet, climbing stairs, getting up a curb, and experience frequent falls.
They may have difficulty turning around, and turn very slowly with multiple little steps.
Gait disturbance is often the most pronounced symptom and the first to become apparent.
In other words, if you notice a love on is having problems walking, or the sound of their feet on the ground changes, you should be concerned.
Most of the above symptoms occurred with my mother. Just about everyone said the same thing--she is getting old.
Mild dementia (mild cognitive impairment) can be described as a loss of interest in daily activities, forgetfulness, difficulty dealing with routine tasks, and short-term memory loss.
The cognitive symptoms associated with NPH are usually less severe than full-blown dementia, and are often overlooked for years or accepted as an inevitable consequence of aging. People with NPH do not usually lose language skills, but they may be less aware of their deficits than those around them, and may even deny that there are any problems.
Not all individuals have an obvious cognitive impairment. In mildly affected cases, conversational skills may be preserved and thinking abilities may be relatively unchanged. In some cases, cognitive changes may only be detectable with formal neuropsychological testing.
Impairment in bladder control is usually characterized by urinary frequency and urgency in mild cases, whereas a complete loss of bladder control (urinary incontinence) can occur in more severe cases.
Urinary frequency is the need to urinate more often than usual, sometimes as often as every one to two hours. Urinary urgency is a strong, immediate sensation of the need to urinate. This urge is sometimes so strong that it cannot be held back, resulting in incontinence. In very rare cases, fecal incontinence may occur. Some people never display signs of bladder problems.
Symptoms of NPH can also resemble those of other conditions affecting the elderly.
For example, t he cognitive deficits of NPH can resemble those associated with early Alzheimer’s or dementia. The gait disturbances of NPH can look similar to those of Parkinson’s and Alzheimer's.
Bob DeMarco is an Alzheimer's caregiver and editor of the Alzheimer's Reading Room. The Alzheimer's Reading Room is the number one website on the Internet for advice and insight into Alzheimer's disease. Bob taught at the University of Georgia, was an executive at Bear Stearns, the CEO of IP Group, and is a mentor. He has written more than 700 articles with more than 18,000 links on the Internet. Bob resides in Delray Beach, FL.