Idiopathic normal-pressure hydrocephalus: Evaluation and findings in a multidisciplinary memory clinic

R. Bech-Azeddine*, G. Waldemar, G. M. Knudsen, P. Høgh, P. Bruhn, G. Wildschiødtz, F. Gjerris, O. B. Paulson, M. Juhler

*Corresponding author af dette arbejde

    Publikation: Bidrag til tidsskriftArtikelForskningpeer review

    Abstract

    The diagnostic evaluation of patients with possible idiopathic normal-pressure hydrocephalus (INPH) is traditionally performed in the settings of either neurological, neurosurgical or psychiatric departments. The diagnostic procedure and findings in 71 consecutive patients referred with a clinical and radiological suspicion of INPH to our out-patient multidisciplinary memory clinic are evaluated. Primary diagnoses and potential concomitant disorders considered of secondary importance for the symptomatologies were established. Abnormal hydrodynamics, demonstrated by intraventricular pressure monitoring and infusion test were mandatory for the diagnosis of INPH. Mean age was 68 years and mean Mini-Mental State Examination (MMSE) score was 22. DSM IV criteria of dementia were fulfilled in 42%. In half of the referred patients (n = 36), the suspicion of INPH was already disproved subsequently to the evaluation programme performed in the outpatient clinic. The main primary diagnosis was cerebrovascular disease (CVD) comprising 27% (n = 19) of the referrals, whereas INPH was diagnosed in only 20% (n = 14). Shunt improvement rate was 72%. The remaining patients were diagnosed as having one of 26 different conditions. A multiplicity of disorders mimics the INPH syndrome, with CVD being the primary differential diagnosis. Evaluating patients with possible INPH in an outpatient multidisciplinary memory clinic is an effective and rational diagnostic approach.

    OriginalsprogEngelsk
    Sider (fra-til)601-611
    Antal sider11
    TidsskriftEuropean Journal of Neurology
    Vol/bind8
    Udgave nummer6
    DOI
    StatusUdgivet - 1 dec. 2001

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