Normal Pressure Hydrocephalus

Signs and symptoms of normal pressure hydrocephalus (NPH)

The typical symptoms of normal pressure hydrocephalus resemble other neurological conditions, especially Alzheimer’s and Parkinson’s. Our neurologists have specialized training to properly diagnose NPH.

We associate three classic symptoms with NPH:

• Difficulty walking
• Problems with bladder control
• Cognitive problems, such as memory loss and difficulty finding words or speaking

Normal pressure hydrocephalus symptoms are usually subtle at first then worsen gradually as fluid builds up in your brain's ventricles. As that happens, the following symptoms can occur.

Gait symptoms include:

• Unsteadiness and leg weakness
• Abnormal gait, including shuffling
• Sudden falls
• Trouble taking a first step, the sensation that feet are stuck to the floor
• Freezing while walking

Urinary symptoms include:

• Frequent urination
• Urgency to urinate
• Urinary incontinence

Mild dementia symptoms include:

• Memory loss
• Speech difficulties
• Apathy and withdrawal
• Changes in mood or behavior
• Problems with attention, reasoning or judgment
• Difficulty concentrating and completing tasks

Other symptoms may include:

• Headaches
• Nausea
• Difficulty focusing eyes

Note that some of these symptoms are part of the normal aging process. But we consider NPH as a possibility if you have urinary tract problems combined with walking and dementia-like symptoms.

NPH diagnosis at UCI Health

It’s important to work with a specially trained neurologist to get a proper diagnosis. Your doctor can refer you to the UCI Health Parkinson's Disease and Movement Disorders Program. 

You can always call us directly to make an appointment. Early diagnosis and treatment are essential to possibly reverse this condition.

What to do if you have symptoms

See your doctor if you find you’re experiencing all three of the typical NPH symptoms:

• Urinary tract issues

• Difficulty with walking and abnormal gait, shuffling, falling

• Dementia-like symptoms

NPH treatment at UCI Health

There is one primary treatment for normal pressure hydrocephalus. 

Once we’ve confirmed an NPH diagnosis, our expert NPH team will use minimally invasive surgical techniques to insert a shunt. The benefits of minimally invasive surgery include fewer side effects and faster recovery times.

This shunt diverts the excess cerebrospinal fluid from your brain. The shunt is a permanent and programmable implant. That means we can monitor and adjust the fluid flow without additional surgery. 

We use a non-invasive sensor system to keep track of the device’s functionality so you can get on with life. To help assess shunt function after implantation, we’ll take additional MRI images to capture CSF flow.

What to expect after treatment

Implanting a shunt doesn’t cure the underlying cause of NPH. 

However, it may greatly relieve your symptoms. In some people, symptoms may improve, but gradually worsen over time. If your symptoms are milder, you will generally respond better. 

Why choose UCI Health for NPH care?

At UCI Health, we have a dedicated Parkinson’s Disease and Movement Disorders Program

Illnesses with a neurological origin are highly complex. Symptoms are often similar and even identical across completely different conditions. 

It’s essential to work with a team of fellowship-trained neurologists who deeply understand NPH and other movement disorders. This ensures that you receive the correct diagnosis and treatment.

We treat you as a whole person, not a collection of symptoms

Dealing with a procedure that involves your brain health can be overwhelming and scary. We educate and involve you at every step to make sure you’re comfortable. As an NPH patient, we follow your progress to ensure that your programmable shunt is performing optimally.

Our neurosurgery team is the only one in Orange County to use magnetic resonance imaging (MRI) to perform flow tests

We use MRI imaging of the cerebrospinal fluid in your brain to assess the fluid dynamics within the brain. This is a specialized technique that helps us pinpoint specifics about your condition.