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This Deadly Disease is Commoner than Doctors Think – and Frequently Missed

Dr Vernon Coleman

Between five and ten per cent of all individuals diagnosed as suffering from Alzheimer’s Disease or dementia have been misdiagnosed and are suffering from normal pressure hydrocephalus; a disorder which can produce similar symptoms – but which can be treated.

Most cases of dementia cannot be treated (though there are a number of things which can be done to slow down the pace at which the disease develops) but there is one particular cause of dementia which can be treated: idiopathic normal pressure hydrocephalus.

If a friend or relative is diagnosed with dementia then you should not accept the diagnosis until doctors have confirmed that the patient is not suffering from idiopathic normal pressure hydrocephalus – a disorder which is commonly misdiagnosed as Alzheimer’s disease, dementia or Parkinson’s disease. If the treatment is started early then the outlook is good.

Idiopathic normal pressure hydrocephalus is bizarrely under-researched, under-diagnosed and under-treated. There is almost certainly no disease affecting large numbers of people which is less understood.

Doctors certainly do not take the disorder as seriously as they should. Within the medical profession it is known (when it is known at all) as the ‘wet, wacky and wobbly disease’ – more a childhood term of abuse than a phrase redolent with respect.

Organisations which specialise in caring for the elderly are often appallingly ignorant about the disease, as are health websites.

On the internet, I asked the questions ‘Why are old people unstable?’ and ‘Why do old people fall so often?’ and none of the first several dozen responses mentioned ‘idiopathic normal pressure hydrocephalus’.

In the UK, the NHS Choices website devotes less than 70 words to the disease and describes the condition as ‘uncommon’ which is manifest nonsense since it affects millions and is undoubtedly the commonest treatable cause of major disability and mental incapacity among the elderly.

Researchers are not interested in investigating the disease because a cure is already available and, since there is no need for a ‘wonder drug’ there are not going to be any big, fat grants from drug companies. And doctors are not interested in diagnosing or treating the disease because it invariably involves older patients, and doctors are encouraged by governments (and much of society) not to take much interest in elderly patients.

If you made a list of the 100 commonest, potentially fatal but most easily cured medical conditions which are most often mistakenly diagnosed as something else, then idiopathic normal pressure hydrocephalus would be top of the list.

Idiopathic normal pressure hydrocephalus is terribly common, it produces devastating results, it is usually mistaken for something else and it is treatable. Patients who have been stuck in bed or in wheelchairs can, after treatment, get up and walk. They can resume their lives; talking and enjoying work and hobbies. Patients who have been abandoned have their lives back again.

A diagnosis of dementia (whether Alzheimer’s or any other variety of dementia) can be devastating to a patient and to family and friends. But that diagnosis is often wrong. And if the correct diagnosis is idiopathic normal pressure hydrocephalus then the true cause of the dementia is treatable.

Under normal circumstances, the space between the brain and the skull is filled with cerebrospinal fluid; a substance which is produced within the spaces of the brain, circulates in and around the brain and is gradually reabsorbed. In normal circumstances, the fluid is produced in the same quantities as it is being reabsorbed. The cerebrospinal fluid, which also surrounds the spinal cord, is there primarily to protect the brain in case of injury.

In the condition known as normal pressure hydrocephalus, the fluid is not reabsorbed as fast as it is produced.

When there is too much cerebrospinal fluid in and around the brain, the liquid accumulates in the ventricles – the spaces within the brain – and the brain is put under pressure, being pushed outwards. The result of this unusual pressure is that the brain is compressed and damaged in a variety of ways. The symptoms and signs of damage will depend upon the area of the brain affected. If the problem is not treated then the damage to the brain will be irreversible.

Logically, one might expect that with too much fluid in a confined space there would be an increase in fluid pressure. By definition, this does not happen with normal pressure hydrocephalus. The intracranial pressure is normal and the increased amount of fluid dilates the ventricular system. If a scan is done, the ventricles usually look dilated. However, even when patients have magnetic resonance imaging (MRI) of the brain, or computerised tomography (CT), the wrong diagnosis can still be made because doctors who are not aware of normal pressure hydrocephalus will probably assume not that the ventricles have become larger but that the brain has become smaller as a result of cerebral atrophy.

Idiopathic normal pressure hydrocephalus, which was first described in 1965 by Salomon Hakim Dow and Raymond Delacy Adams, does not appear to be any commoner in men than in women or in women than in men and there is not as yet any evidence showing whether it is especially likely to affect any particular racial or ethnic groups. Although it can affect people of any age, it does, however, seem to be most commonly seen among patients in their 60s or older and it is this which results in patients being so often misdiagnosed as suffering from Alzheimer’s disease.

The initial, main symptom is often a curious, wide legged, unsteady walk. The patient’s feet seem to stick to the floor, and have to be dragged up in order to make the next step. Patients adopt a wide legged gait in an attempt to make themselves more stable but they are, nevertheless, often unstable and may fall. Indeed, falling is a common problem with patients suffering from idiopathic normal pressure hydrocephalus and in any elderly person who falls frequently, the possible diagnosis of idiopathic normal pressure hydrocephalus should be placed quite high up on the list of possible causes.

Sadly, it is still the case that many leading health websites do not even mention normal pressure hydrocephalus as a possible cause of falls though the disorder should be listed towards the top of any such list, together with balance problems and drug side effects.

(continues)

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Faith's avatar

During COVID, many patients besides the disabled have been murdered in American hospitals, and they callously have done it just for the huge government "bounty" paid out for murdering COVID patients. We will never know exactly how many, but it is pretty safe to say that the vast majority of "COVID deaths" were indeed deliberate murders since COVID is a highly treatable disease, especially when treatment is started in a timely manner. With proper treatment nobody should have died unless they were already on their deathbed from some coexisting condition such as cancer.

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