I found this article in the Alzheimer's Reading Room. I found it quite interesting and wanted to share.

The symptoms of NPH can occur in Alzheimer disease and Parkinson disease. However, the combination of dementia-like symptoms, walking problems, and urinary problems should alert your health care provider to the possibility of NPH. Making the distinction is very important because the treatments for these conditions are quite different. Tests are available that can confirm the diagnosis. At any point in this process, your health care provider may refer you to a specialist in brain disorders (neurologist or neurosurgeon) to complete the evaluation and begin treatment.
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What is Normal Pressure Hydrocephalus?

Normal pressure hydrocephalus (NPH) is an abnormal increase of cerebrospinal fluid (CSF) in the brain's ventricles, or cavities. It occurs if the normal flow of CSF throughout the brain and spinal cord is blocked in some way. This causes the ventricles to enlarge, putting pressure on the brain. Normal pressure hydrocephalus can occur in people of any age, but it is most common in the elderly population. It may result from a subarachnoid hemorrhage, head trauma, infection, tumor, or complications of surgery. However, many people develop NPH even when none of these factors are present. In these cases the cause of the disorder is unknown.

Symptoms of NPH include progressive mental impairment and dementia, problems with walking, and impaired bladder control leading to urinary frequency and/or incontinence. The person also may have a general slowing of movements or may complain that his or her feet feel "stuck." Because these symptoms are similar to those of other disorders such as Alzheimer's disease, Parkinson's disease, and Creutzfeldt-Jakob disease, the disorder is often misdiagnosed. Many cases go unrecognized and are never properly treated. Doctors may use a variety of tests, including brain scans (CT and/or MRI), a spinal tap or lumbar catheter, intracranial pressure monitoring, and neuropsychological tests, to help them diagnose NPH and rule out other conditions. In September 2005 an international team of scientists developed clinical guidelines to help physicians diagnose NPH. The guidelines were published as a supplement to the journal Neurosurgery ("Diagnosing Idiopathic Normal-pressure Hydrocephalus," Vol. 57(3), Supplement: S2-4--S2-16, 2005).

Jeanne

I saw an info mmercial on this on TV a few years ago. A man had all the symtoms as described, could barely even function any longer. But with correct diagnosis and treatment he was pretty much back to normal and actually returned to work.

When I questioned my moms doctor about it, he said that she didn't show the normal signs, and as usual, wouldn't even do the dang tests to be sure.

What if each person with this doesn't show the same signs?

Here again, the problem is getting the specialists to just do the testing to rule out other possibilities when you suggest them.

It's our lives we're dealing with here, but it's always a battle with the doctors to try different things, or even run some of the simplest tests.

I just lost a friend to a cancer, if when she first started noticing certain signs in her body, they had run a certain simple blood test, it may have saved her life.

We have to know our own body, and fight and insist on further testing, sometimes urgently, and even then it's a matter of how much insurance you have and if they will pay for the testing.

Grrrrrr....sore subject for me.

I would seek out Neurologists in the area and ask specifically, on the phone, if they would be willing to test for NPH. It would be so wonderful if we found out that what is ruining the lives of our LO's was a curable but mis-diagnosed illness. My DH has all the symptoms of NPH as do most AD patients. I wonder if NPH is passed along like AD. We have an appt with UTSW next month and I will ask about it. UTSW is an AD Research Center so they should not have a problem with the test, or can at least tell me why it's not a probable diagnosis. JAB, our resident expert, your thoughts please on NPH.

A CT scan (CAT scan) or MRI will usually show NPH, since it causes the ventricles of the brain to enlarge due to increased cerebrospinal fluid within the skull. Patients are misdiagnosed as having AD when the doctor doesn't bother to run one of these tests -- which are standard for diagnosing patients who have dementia symptoms.

If the brain imaging shows enlarged ventricles, the neuro can try one or more tests to determine whether shunting will help reduce the symptoms, such as lumbar puncture or spinal tap, lumbar catheter, etc.

http://alzheimers.boomja.com/N...lus-(NPH)-26478.html

What is the treatment for NPH that they used on the patient that was able to return to work? I'm overwhelmed right now and my internet keeps going down so I can't research this very well.

Thanks, Felicia

Felicia, it's surgery to install a "stent" that continously drains the excess fluid from the brain to, if I remember correctly, the abdomen. That link in my post above yours has tons of information on NPH, diagnosis, determining who's a good candidate for the surgery, etc.