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Normal Pressure Hydrocephalus: Fluid, Motor Function, Speech, & Thinking

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Normal Pressure Hydrocephalus (NPH) is another dementia that is often misdiagnosed, typically because of shared characteristics with Alzheimer's or Parkinson's. NPH is caused by a buildup of cerebrospinal fluid in the brain that results in damage or disrupted activity in the brain from the ventricles enlarged by the excess fluid.


The parts of the brain most affected by NPH are the control centers for leg movement and coordination, bladder control, and some cognitive functioning--including memory, speaking, valid reasoning, and problem solving. These deficits manifest by symptoms in three primary areas, including:

  • Disturbances or imbalance in gait

  • Incremental loss of bladder control (incontinence)

  • Dementia

Treatment & Prognosis

There exists no definitive understanding of the cause for blockages experienced in NPH. Because the main problem is a buildup of fluid, one might consider diuretics as an option; however, it has been shown that diuretics have not been helpful in controlling the buildup of cerebrospinal fluid. The surgical implanting of a long, thin shunt is an options. This procedure allows excess fluid to drain from the brain to the abdomen, and then be absorbed and discarded through urination. Although shunting has shown positive results in reducing difficulties in walking, it concurrently exacerbates the challenge of bladder control. It is important to discuss thoroughly the prospect of getting this shunt procedure because, as with most surgical procedures, the post-surgical complications may outweigh the benefits of the surgery, since shunting does not appear to have long-term benefits.


Lists in this article adapted from Earlstein, F. (2016). Dementia Facts & Information. NRB Publishing: Nevada.

For more resources and references on Normal Pressure Hydrocephalus (NPH), see the following:

Normal Pressure Hydrocephalus News & Research:



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