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34 - Therapy of idiopathic normal pressure hydrocephalus

Published online by Cambridge University Press:  23 December 2009

By
Dennis A. Nowak
Edited by
Dennis A. Nowak  and
Joachim Hermsdörfer
Dennis A. Nowak
Affiliation:
Klinik Kipfenberg, Kipfenberg, Germany
Joachim Hermsdörfer
Affiliation:
Technical University of Munich
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Summary

Summary

The clinical spectrum of idiopathic normal pressure hydrocephalus (INPH) comprises gait impairment, cognitive decline and urinary incontinence, all associated with ventricular enlargement and normal cerebrospinal fluid (CSF) pressure on random spinal taps. There is significant variation in the clinical presentation and progression of the disorder and correct diagnosis frequently represents a challenge to the clinical neurologist. Several reports have suggested that the motor disability to be found in INPH may also involve the upper limbs and recent reports provide direct kinetic evidence for this suggestion. Grip-force analysis may also allow an objective evaluation of the beneficial effects of therapeutic strategies in this entity. This chapter reviews the pertinent literature upon the kinetic assessment of upper limb motor disability in the diagnosis and therapy of INPH.

The symptom complex of INPH

Idiopathic normal pressure hydrocephalus (INPH), first described by Hakim & Adams (1965) and Adams et al. (1965), is characterized by the clinical triad of gait disorder, dementia and urinary incontinence, all in the presence of ventriculomegaly and normal cerebrospinal fluid (CSF) pressure on random lumbar puncture. The cause of INPH is not known. When the clinical syndrome occurs as a result of other diseases, such as hemorrhage, traumatic brain injury, cerebral infarction or meningitis, it is referred to as secondary normal pressure hydrocephalus (Gallia et al., 2006). The incidence of INPH has been reported to be about two cases per 100,000 individuals (Vanneste et al., 1992; Krauss & Halve, 2004).

Type
Chapter
Information
Sensorimotor Control of Grasping
Physiology and Pathophysiology
 , pp. 482 - 490
Publisher: Cambridge University Press
Print publication year: 2009

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