Idiopathic normal pressure hydrocephalus
A couple of weeks ago we mentioned iNPH, or idiopathic normal pressure hydrocephalus, as a form of dementia that often masquerades as Alzheimer’s disease or Parkinson’s disease — but isn’t. The reason it’s so important to be aware of this condition is because dementia caused by iNPH can be controlled or reversed with proper treatment. The Hydrocephalus Association estimates that more than 700,000 Americans (twice the number from 10 years ago) have iNPH. The average age of onset is about 70 years old; men and women are affected in equal numbers; and less than 20 percent receive an appropriate diagnosis and treatment.
But, you ask, if things are “normal,” what’s the problem?
That misnomer came from one of the earliest papers written about the condition. In 1964, Dr. Salomon Hakim described the neurologic symptoms of dementia accompanied by gait disturbances and lack of bladder control. Those three symptoms —which is what a good
specialist will look for when diagnosing iNPH — were thought to be going on even though there was no perceived fluid buildup in the brain. But now we know that’s wrong. There is fluid — and hence, pressure — buildup in the brain.
With today’s scanning technologies using a CT or MRI, doctors can see exactly where a buildup of cerebral fluid is occurring. And we know how to alleviate the pressure, and hopefully reverse the symptoms. So now you can think of the name of the condition as a tag identifying where you want to be and what you want to achieve: normal pressure.