Is it Really Dementia?

Given the public awareness about dementia and Alzheimer’s Disease, when clients in our home care business are diagnosed with the disease, the normal conclusion by family members is that the diagnosis is accurate.

Research, however, suggests that as much as five percent of patients diagnosed with dementia actually have a treatable condition known as normal pressure hydrocephalus, or NPH.

NPH is an increase of cerebrospinal fluid in the cavities of the brain.  It is believed to take place when the normal flow of fluid is blocked, perhaps as a result of head trauma, infection or post-surgery complications.  Experts say that NPH can present itself even when these underlying conditions have not occurred.  Excess fluid causes increased pressure within the brain and the resulting symptoms are very similar to those of dementia:

• progressive cognitive decline
• difficulty with ambulation
• poor control of the bladder
• general slowing of physical movement

If your loved one has NPH, the good news is that treatment is relatively straightforward.  The standard procedure is to insert a shunt in the brain to drain excess fluid into the abdominal cavity where it can be absorbed.   Some people experience a complete recovery and resume their normal lives.  There are reports of patients whose symptoms were so advanced that they had actually been moved to Assisted Living Facilities before being reevaluated.  Following the procedure for NPH, they went back home and resumed their normal routines.

Since the symptoms of Normal Pressure Hydrocephalus are similar to those of other disorders such as Alzheimer’s, Parkinson’s and Creutzfeldt-Jakob, it is believed that many cases go unrecognized and are never properly treated.   If you think that your loved one has NPH, there are a number of tests that can be performed.  These include brain scans (CT and/or MRI), spinal taps or lumbar catheters, intracranial pressure monitoring and neuropsychological tests.

In 2005, the medical community published guidelines to help the diagnosis of NPH.   These were published as a supplement to the journal Neurosurgery (“Diagnosing Idiopathic Normal-pressure Hydrocephalus,” Vol. 57(3), Supplement: S2-4–S2-16, 2005).

As with all diseases, earlier diagnosis and treatment improves the chance of a good recovery. For more information, consider these resources:

Hydrocephalus Association

4340 East West Highway – Suite 905

Bethesda, MD   20814

www.hydroassoc.org

Tel: 301-202-3811

National Hydrocephalus Foundation

12413 Centralia Road

Lakewood, CA   90715-1653

www.nhfonline.org

Tel: 562-924-6666