It's a neurological disease that is treatable, but the trick is getting the right diagnosis.
"I couldn't walk properly. I couldn't keep my balance. You start to feel like your feet are attached to the floor, and you can't pick your feet up. I couldn't get my words out," said Ramona Luckman, who had been diagnosed with Parkinson's disease.
In 2007, a doctor told Luckman, 69, her symptoms added up to one thing -- Parkinson's. "That just threw me for a loop, and I started to cry."
But two agonizing years later, CT scans confirmed that Luckman didn't have Parkinson's at all. It was NPH -- normal pressure hydrocephalus. NPH is a buildup of cerebral spinal fluid that enlarges the ventricles.
"They believe that the symptoms are a result of the expansion of these fluid-filled spaces," said Dr. Joseph Zabramski.
Although symptoms of NPH can mimic Parkinson's, dementia or even Alzheimer's, treatment for this neurological disorder is very different. A programmable shunt was placed in Luckman's brain. It drains about a cup of fluid a day through a long tube into her abdomen.
"What happens is when you start to drain the fluid, the patient's symptoms dramatically resolve," Zabramski said.
"It worked," Luckman said. "I feel that I've got about 85 to 90 percent of my abilities back."
Now, with a steady hand and an eye for every detail, she's healthy, happy and back in control.
More than 750,000 Americans may be living with NPH, with many of those unaware they are affected. Studies show about 5 percent of dementia is actually caused by NPH, not Alzheimer's.
Though NPH can occur at any age, it's most commonly seen in adults over 60.
BACKGROUND: Normal pressure hydrocephalus (NPH) affects more than one in every 200 adults over the age of 65. This condition is characterized by an abnormal accumulation of cerebrospinal fluid (CSF) within cavities (called ventricles) inside the brain. When the path of the CSF is blocked, fluid begins to accumulate, causing the ventricles to enlarge and the pressure inside the head to increase. This disease is commonly mistaken for Alzheimer's, Parkinson's or simply old age because of the similarity in symptoms. (SOURCE: Hydrocephalus Association)
SYMPTOMS: The symptoms of NPH include gait disturbances ranging from a mild imbalance to an inability to walk or stand; mild dementia that includes loss of interest in daily activities and forgetfulness; and impairment in bladder control, ranging from urinary frequency and urgency to total loss of bladder control. (SOURCE: Barrow Neurological Institute)
TREATMENT: The good news is that once detected and treated, the symptoms can be reversed. This condition is treated through a procedure where a shunt is placed in the brain to absorb the excess fluid that's causing the NPH. (SOURCE: Hydrocephalus Association)
PARKINSON'S VS. NPH: According to the Department of Neurological Surgery at the University of California, Irvine, 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. Older patients with NPH appear not to have involuntary movements, tremors, tingling or pain in the hands and feet, or numbness associated with Parkinson's disease or other neurological conditions. However, a feeling of weakness in the arms and legs and stiffness in gait is not uncommon for patients with NPH. Also, cognitive decline in those with NPH appears late or not at all.
FOR MORE INFORMATION:
Carmelle Malkovich, Public Relations
Barrow Neurological Institute
(602) 406-3319
Carmelle.Malkovich@CHW.EDU
