A Treatable Condition Misdiagnosed as Alzheimer’s

I came across an article1 in Parade magazine that motivated this post. There is a condition, Normal Pressure Hydrocephalus (NPH), that is frequently misdiagnosed as Alzheimer’s, Parkinson’s, or Creutzfeldt-Jakob disease. Worse yet, sometimes it is attributable to aging. This is a tragedy because NPH is treatable. The most distinguishing feature of NPH is a disturbed gait while walking. Memory losses and a loss of bladder control are other symptoms. These symptoms occur gradually. NPH occurs when the cerebrospinal fluid (CSF) surrounding the brain fails to be reabsorbed. Treatment for NPH involves the surgical implantation of a shunt in the brain to drain excess CSF into the abdomen where it can be reabsorbed.

Although this disease can occur at any age, it is more prevalent in the elderly. The Hydrocephalus Association estimates that at least 350,000 Americans, and 5 percent of people with dementia, have the condition. Mark Luciano, M.D., the director at Cleveland Clinic says that about 30 percent of his NPH patients were originally told that they had Alzheimer’s or Parkinson’s.

In the case of Jimmy Nowell that was discussed in the Parade article, one specialist diagnosed his condition as Parkinson’s. Another specialist diagnosed it as Alzheimer’s. Had Nowell and his wife stopped at this point, his conditioned would have worsened until he died. Unless an autopsy had been taken, everyone would have thought he had died of Alzheimer’s. If an autopsy had been done they would have discovered that the distinctive plaque and neurofibril tangles were missing and would have been pondering as to what killed him. Fortunately they found a neurologist who correctly diagnosed the condition when he took an MRI and compared it to an MRI taken several years earlier. His treatment was successful.

I confess my ignorance of NPH until reading the Parade article. I had mistakenly thought that I was fairly familiar with the literature in the Alzheimer’s area. Unfortunately, I am not alone in my ignorance as it is apparently shared by too many in the medical community. Please spread the word regarding NPH, so that people suffering from the condition mistakenly think they have or are misdiagnosed with another condition. NPH is a condition that can be successfully treated.


1Chen, J. (2012). What If Grandpa Doesn’t Really Have Alzheimer’s? Parade, November 11, p.22

© Douglas Griffith and healthymemory.wordpress.com, 2012. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

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