At 79, Tamar wasn’t ready to slow down: She walked three miles a day, was a whiz at Sudoku puzzles, and loved hiking with her husband. But within just a year, she had sharply declined. The once-vibrant septuagenarian could no longer get out of a chair unassisted, didn’t understand how to use a telephone, and had become incontinent. “She was a shell of her former self,” remembers her daughter Iris. “Her physician told us that she had atypical Alzheimer’s disease and that nothing could be done for her.”
Frustrated, Iris and her sisters brought their mother to the Memory Disorders Unit at Mass General, where she failed a series of cognitive tests. The situation seemed hopeless. Then, an ordinary dinner out changed everything. As Iris described her mother’s symptoms, a friend at the table said she thought they sounded familiar. Later, she gave Iris a newspaper clipping describing a man’s struggle with normal pressure hydrocephalus, or NPH. “We’d never heard of NPH before,” says Iris. “But our family decided we wanted Mom to be evaluated for it.”
A TRICKY DIAGNOSIS
It may not be a household name, but NPH is increasingly being recognized as a potential cause of symptoms like Tamar’s. In this disorder, excess cerebrospinal fluid accumulates in the ventricles of the brain, leading to a triad of classic symptoms: gait abnormalities, cognitive difficulties, and loss of bladder control. Yet these symptoms often mimic other conditions common in people over age 60, including Alzheimer’s disease, Parkinson’s disease, prostate problems, and overactive bladder, explains Steven E. Arnold, MD, Translational Neurology Head of the Interdisciplinary Brain Center at Mass General. “NPH is a very difficult diagnosis to make,” he says. “But, as one of the only treatable forms of dementia, it’s also an incredibly important diagnosis.”
To address the need for streamlined evaluation and treatment of NPH, Arnold has joined with William T. Curry, MD, an attending in the hospital’s Department of Neurosurgery, to create the Normal Pressure Hydrocephalus Program.