TY - JOUR

T1 - Idiopathic normal-pressure hydrocephalus

T2 - evaluation and findings in a multidisciplinary memory clinic

AU - Bech-Azeddine, R

AU - Waldemar, G

AU - Knudsen, G M

AU - Høgh, P

AU - Bruhn, P

AU - Wildschiødtz, G

AU - Gjerris, Flemming

AU - Paulson, O B

AU - Juhler, M

PY - 2001/11

Y1 - 2001/11

N2 - 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.

AB - 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.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Ambulatory Care Facilities/organization & administration

KW - Dementia, Vascular/diagnosis

KW - Diagnosis, Differential

KW - Female

KW - Humans

KW - Hydrocephalus, Normal Pressure/diagnosis

KW - Male

KW - Memory Disorders/diagnosis

KW - Middle Aged

KW - Patient Care Team/organization & administration

KW - Patient Selection

KW - Prevalence

KW - Program Evaluation

KW - Referral and Consultation/statistics & numerical data

U2 - 10.1046/j.1468-1331.2001.00291.x

DO - 10.1046/j.1468-1331.2001.00291.x

M3 - Journal article

C2 - 11784345

VL - 8

SP - 601

EP - 611

JO - European Journal of Neurology

JF - European Journal of Neurology

SN - 1351-5101

IS - 6

ER -