'NPH' under-diagnosed geriatric illness:Doctors

Kochi, Aug 23 (UNI) Often mistaken for Parkinson's or Alzheimer's, Normal Pressure Hydrocephalus or 'NPH' is a much-underdiagnosed geriatric illness which can cause a lot of problems, including dementia and uninary incontinence, neurosurgeons said today.

Addressing a press conference here, Dr Mahesh and Dr Ramesh V Nair of Lakeshore Hospital said 'NPH' normally occurs in adults of 55 years and older. It is caused by an accumulation of cerebrospinal fluid (CSF), which results in the ventricles of the brain enlarging, which in turn stretches the nerve tissue of the brain causing a triad of symptoms.

Normally, the CSF, which cushions the brain and spinal cord tissue, is absorbed by the bloodstream. However, when an imbalance occurs, excess CSF results in the condition known as 'Hydrocephalus'. Left untreated, it creates increased pressure in the head and may even result in brain damage, they said.

The three main symptoms characterizing the disease, which is often mistaken for Parkinson's or Alzheimier's, is gait disturbance, dementia and urinary incontinence, the doctors said.

Diagnostic procedures such as ultrasound, CT, MRI and intracranial pressure (ICP) monitoring can be done to test for 'NPH'.

Talking of treatment, the doctors said while medicines or 'Lumbar Puncture' might give some relief, they have found placement of a 'CSF shunt' to be very useful in giving long-term relief.

The shunt drains away excess CSF to the abdomen, where it is absorbed easily.

Mr David Thobias, an 'NPH' patient who underwent the shunt placement at Lakeshore Hospital a year ago, said that the procedure had resulted in a dramatic improvement in his condition.

''I had been on medicines for the past three years but these had given me only temporary relief. Problems such as urinary continence were making my life terrible,'' the 62-year-old said.

Dr Mahesh said while normal shunts are priced between Rs 1,500 and Rs 20,000, they had implanted a 'programmable shunt system' in Mr Thobias. The advantage of this was that in case the patient's parameters undergo a change, pressure adjustments can be made in the shunt without a second surgery. The cost of this shunt is Rs 70,000.

The procedure required a post-operative stay of seven days in the hospital, he said.

UNI