It is estimated that 250,000 Americans over the age of 65 may have been misdiagnosed with Alzheimer’s disease, and perhaps Parkinson’s disease, when in fact they have a treatable condition known as normal pressure hydrocephalus, or NPH.
Now, Dr. Marvin Bergsneider, associate professor-in-residence in the UCLA Division of Neurosurgery, has been awarded a $1 million grant from the National Institutes of Health to further investigate what causes the condition and to develop treatments that lower risks and improve results. The UCLA study, which is funded for four years, will begin in February.
NPH is a relatively new disorder, first recognized in 1965. It is not well-known among the public and, more importantly, is often overlooked by physicians, said Bergsneider, who directs UCLA’s Adult Hydrocephalus Program, which has treated more than 500 NPH patients over the past 12 years.
Hydrocephalus is a condition in the brain characterized by an abnormal buildup of cerebrospinal fluid. In the elderly, this can cause difficulty walking (an unsteady and/or shuffling gait), poor bladder control (urgency and/or incontinence) and short-term memory loss. But because all of these symptoms are relatively common in the elderly population, a diagnosis of NPH is often not considered.
In cases involving more advanced symptoms of NPH, the condition may be frequently mistaken for better-known and more common disorders, including Alzheimer’s and Parkinson’s. While the clinical triad of gait disturbance, poor bladder control and memory loss represents the hallmark findings for a diagnosis of NPH, the key test missing in most misdiagnosed cases, said Bergsneider, is an MRI or CT scan of the brain, which is not routinely performed. The enlargement of the ventricles typical of NPH is easy to identify with either of these imaging tools, and it is often the radiologist who raises the possibility of NPH.
Treatment is available for those suffering from NPH. A shunt is surgically inserted in the brain to drain the cerebrospinal fluid to another part of the body, typically the abdominal cavity. Tremendous improvement is seen in some who undergo the procedure.