NPH - Misdiagnosed Dementia
Three most common symptoms - not everyone has all 3 symptoms. Defined by awordlover
Written 4/1/2013 by Anne DiGeorge
These three most common symptoms of NPH -Normal Pressure Hydrocephalus are usually missed by most doctors. Unless a patient, or the patient's advocate, does their homework and asks the physician to consider NPH, the diagnosis the patient receives can determine the way he lives out his life. That will usually be either with a full time in-home caregiver or in a nursing home.
- Gait Impairment (walking problems)
Not all patients with NPH will have all three of those symptoms, but those are the top three that tip off doctors. A patient with NPH could have just one of those three and a few of the other symptoms listed below.
Take a look at the 15 diseases/conditions I listed in the next two columns. While you are reading, I want you to look for common denominators to see how similar any or all are to the above three symptoms.
Misdiagnosed Conditions (continued).Researched by awordlover
8. Creutzfeldt-Jakob Disease
- behavioral changes
- failing vision
- problems with thinking and judgement
- memory problems
- unsteady gait
- speaking difficulty
9. Vascular dementia - usually the result of TIA or stroke
- problems with memory
- slowed thinking and learning
- shuffling walk
- balance and falling issues
- language and speech problems
- difficulty with organizational skills
- mood and personality changes
- wandering, getting lost
- excessive thirst
- excessive urination
- weight loss
- blurred vision
11. Pick's Disease
- social withdrawal
- poor judgement
- mood swings
- decline in ability to function effectively in activities of daily living
12. Huntington's Disease
- short-term memory loss
- problems with organization
- concentration problems
13. Prion Diseases
- Personality changes
- Lack of coordination
- Unsteady gait
- Memory problems
- Inability to speak
14. ADHD - Attention Deficit Hyperactive Disorder
- Not paying attention
- Lack of attention
- Poor attention span
- Easily distracted
- Failure to listen to instructions properly
- Getting bored very easily
- Difficulty coping with details
- Careless mistakes in work
15. Wernicke-Korsakoff Syndrome
- Reduced eye movement
- Staggering gait
Misdiagnosed Conditions - Researched by awordlover
Those three symptoms could be any one of these conditions. The lists are not a complete list of that one disease. I have listed only those symptoms that are similar.
1. Parkinson's Disease
- balance difficulty,
- shortened stride length
- difficulty turning
2. Alzheimer's Disease
- memory loss
- loss of concentration
- more than usual forgetfulness
3. T.I.A. (transient ischemic attack)
- numbness or weakness in the face, arm, or leg, especially on one side of the body
- difficulty in talking or understanding speech
- trouble seeing in one or both eyes
- difficulty with walking
- loss of balance and coordination
- Emotional changes
- Personality changes
- Behavior changes
- Lack of awareness of mental changes
- Temporary limb weakness
- Limb tingling
- Trouble speaking
- Trouble understanding speech
- Dim vision
- Loss of vision
- Trouble walking
- Loss of balance
- Loss of coordination
- Incoherent speech
- a loss in interest in activities once enjoyed
- chronic fatigue
- trouble focusing
- difficulties with memory or in making decisions.
- sleep abnormalities or disturbances
Do not copy this article. It is not free for the taking just because it is on the internet.
Suggested by awordlover
- How Common is Failure to Diagnose? - RightDiagnosis.com
To examine how commonly failure-to-diagnose or delayed diagnosis occurs, here is a list of conditions according to the number of people undiagnosed.
Wrong Diagnosis - Researched by awordlover
Isn't that list amazing? How can so many diseases be so similar to one another? An even better question, how can doctors make any kind of definite diagnosis without getting it wrong?
Therein lies the rub.
They do get it wrong, at least 40% of the time, according to the American Medical Association.
Every year, patients are given one of those listed conditions as a final diagnosis that can mean the end of life as they know it. Many people have been treated for one of them, sometimes for as long as 15 years, before some inquisitive and "listening" doctor comes along and says, "I wonder if..."
This surgery will not help everyone. It is only a suggestion for your consideration.
What is NPH?
So what is the medical definition of NPH?
NPH is essentially water on the brain, caused by a build up of spinal fluid that puts pressure on the nerves that govern the legs, bladder and cognition functions. The symptoms are similar to Alzheimer's Disease, dementia and any number of neurological brain disorders, except with NPH, the symptoms can be reversed.
It usually strikes people over age 55 and, if caught early enough, a surgery can be performed that will eliminate most of the symptoms. While it IS brain surgery and many patients are afraid of that, this procedure has been performed thousands of times with great success. It can make all the difference in your quality of life.
Very good video explaining NPH - From Beginning Symptoms to Treatment. Suggested by awordlover
72 year old diagnosed with Alzheimer's Disease
Article Suggestion by awordlover
Jim Lambert was a 72 year old retired hospital fundraiser. One night he got up to go to the bathroom and felt on the floor. His symptoms quickly kicked in: inability to walk a straight line, bladder and bowel incontinence, and a shuffling walk. He was diagnosed with Alzheimer's Disease, but his wife couldn't continue taking care of him because of her own health problems. He was admitted to a nursing home, spent his days slumped in a wheelchair and could not stand on his own. His wife didn't believe he had Alzheimer's and started investigating. Three years later he had a diagnosis of NPH. You can read his story here.
Symptoms for NPH - Normal Pressure Hydrocephalus
List of symptoms for NPH - Researched by awordlover
- Unsteadiness on standing
- Difficulty in get started with the walking motion
- Inappropriate repetition of movements
- Flat expression on face, no mood
- Urinary incontinence
- Loss of bladder control
- Shuffling feet
- Forgetfulness, short term memory loss
- Falls, without losing consciousness (also called drop attacks)
Again, you do not have to have all of the above symptoms for it to be NPH. The primary symptoms physicians should be looking for are: incontinence, some degree of memory problems or dementia, and changes in walking functions.
Tests for NPH
- CT scan
- Lumbar puncture
- Radionuclide imaging studies
- Neurological exam
- Physical therapy evaluation
- CT scan
- MRI followed by lumbar puncture (spinal tap)
Treatment for NPH - Researched by awordlover
A neurosurgeon implants a permanent shunt (a small tube) that drains out a small amount of spinal fluid every day to prevent build up inside the brain. Then a a tube is threaded under the skin, down to another part of the body, usually the belly. A valve is opened to release the fluid when the pressure builds up. The fluid drains out of the brain and is absorbed by the bloodstream.
Results are seen immediately after surgery. Patients with the least amount or severity of symptoms see the most relief. Some patients might need a cane for support, but the mental deficits are remarkably improved.
Without treatment, the patient gets progressively worse until he cannot walk or do simple tasks. Falls become more frequent, and the patient becomes totally dependent on someone for care. Life span is markedly shortened.
If you notice a change in mental status of your loved one, seek immediate medical attention and keep NPH in mind when being evaluated for a diagnosis.
Treatment Plan - Surgery - suggested by awordlover
Dick Wagner, songwriter for Alice Cooper's Band
Article suggested by awordlover
Dick Wagner, age 70, went through five years of dementia-like symptoms before he received his diagnosis of NPH. Now he's back writing and performing with the band. You can read his story here.
Often found In aging adults
It is believed that one in 20 people who have been diagnosed with Alzheimer's Disease or dementia actually have NPH, Normal Pressure Hydrocephalus.
But they won't get that diagnosis because most doctors rarely order an MRI or CT scan of the brain and patients are in no condition to ask for them. Doctors address the symptoms they can see, not what is really going on inside the brain.
Not all dementia leads to Alzheimer's Disease. However, once a patient receives a diagnosis of Alzheimer's Disease, he/she will rarely look any further for another reason for their symptoms. They accept the diagnosis and medication for treatment, watching their quality of life change forever.
And that's not right. If more patients questioned their "bad news" and put their doctors on the spot, it could greatly cut the numbers of people misdiagnosed every year.
Looks like Alzheimer's, but it's Frontotemporal Dementia
Article suggested by awordlover
Although this case is not NPH, I wanted to show you how strikingly similar other dementia diseases are. This story interested me because of the age of the patient.
Kenny Sparks, age 49, began stumbling over his words, became agitated, stressed, and depressed. He was given medication for depression, but it didn't help the other symptoms. He was diagnosed with Alzheimer's Disease. The doctor told his family if they wanted to do any traveling to get it done in the next few years before he became incapacitated from the disease. He was diagnosed with Frontotemporal Dementia and you can read about his story here.
Second Opinion - Advice by awordlover
To anyone who has received a diagnosis of dementia, Alzheimer's Disease or any of the diseases or disorders I have listed above:
- Please go get a second opinion.
- Go get a 3rd or 4th opinion, if you don't like what you are hearing.
- Do not accept a final diagnosis without a CT scan or an MRI followed by a lumbar puncture (spinal tap)
I would much rather see a patient go through the evaluation and testing using lumbar puncture with imaging studies and be sure of a diagnosis, than to accept a diagnosis based on evaluating symptoms without the benefits of those tests.
It's your life. It's your health. Take the gamble that a doctor may be wrong. Even if it turns out he was right, at least you have ruled out all other possibilities.
Copying is stealing
Written 4/1/2013 by Anne DiGeorge
Updated 1/14/2014 with links and videos by Rachael O'Halloran
Updated 2/2//2014 by Rachael O'Halloran to replace pixelated copscape logos and correct format issues.
© 2014 awordlover