About Normal Pressure Hydrocephalus (NPH)

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Normal Pressure Hydrocephalus is a neurological condition which normally occurs in adults 55-years and older. NPH is an accumulation of cerebrospinal fluid (CSF) causing the ventricles of the brain to enlarge, in turn, stretching the nerve tissue of the brain causing a triad of symptoms.


How is NPH different from Alzheimer's or Parkinson's?

One quarter million Americans with some of the same symptoms as dementia, Alzheimer's, or Parkinson's may actually have NPH.

It’s often difficult to tell the difference because the symptoms of NPH are in many ways similar to those of Alzheimer’s or Parkinson’s. However, the feeling of feet glued to the floor, or difficulty walking is the first symptom to appear in NPH. And it’s different from, for example, Parkinson’s tremors. In Alzheimer’s, memory loss and confusion tend to be early symptoms, whereas in NPH these appear later. Fortunately, once NPH is confirmed, chances are it can be treated.

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More About Hydrocephalus

Hydrocephalus is an abnormal (excessive) accumulation of fluid in the head. The fluid is called cerebrospinal fluid, commonly referred to as CSF. The CSF is located and produced within cavities of the brain called ventricles. The function of CSF is to cushion the delicate brain and spinal cord tissue from injuries and maintain proper balance of nutrients around the central nervous system. Normally, the bloodstream absorbs most of the CSF produced on a daily basis. Every day your body produces a certain amount of CSF and that same amount of CSF is absorbed in the brain. When an imbalance occurs, an excess of CSF fluid builds up resulting in the condition known as hydrocephalus. Left untreated, hydrocephalus will create increased pressure in the head and may result in increased symptoms or brain damage.


SYMPTOMS OF NPH

Characterized by three primary symptoms, NPH patients usually exhibit:

* Gait disturbance (difficulty walking)
* Dementia or forgetfulness
* Urinary incontinence (bladder control)

However, not all symptoms are always apparent or present at the same time.

>> View a video of the NPH gait: http://www.lifenph.com/symptoms.asp


It's not just "old age"

Because these three symptoms are often associated with the aging process in general, and a majority of the NPH population is older than 60 years, people often assume that they must live with the problems or adapt to the changes occurring within their bodies. Symptoms can be present for months or even years before a person sees a physician. The symptoms of NPH seem to progress with time. The rate of progress is variable, and it is often a critical loss of function, or disability, that brings patients to their doctors. It seems that the longer the symptoms have been present, the less likely it is that treatment will be successful. As a general rule, the earlier the diagnosis, the better the chance for successful treatment, but some people experiencing symptoms for years can improve with treatment.

Gait disturbances range in severity, from mild imbalance to the inability to stand or walk at all. For many patients, the gait is wide-based, short, slow and shuffling. People may have trouble picking up their feet, making stairs and curbs difficult and frequently resulting in falls. Gait disturbance is often the most pronounced symptom and the first to become apparent.


Forgetfulness or mild dementia

Mild dementia can be described as a loss of interest in daily activities, forgetfulness, difficulty dealing with routine tasks and short-term memory loss. People do not usually lose language skills, but they may deny that there are any problems. Not everyone will have an obvious mental impairment.


Urinary incontinence

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 patients never display signs of bladder problems.