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01-04-2021 | Hydrocephalus | Original Communication

iNPH with parkinsonism: response to lumbar CSF drainage and ventriculoperitoneal shunting

Authors: Giovanni Mostile, Giacomo Portaro, Francesco Certo, Antonina Luca, Roberta Manna, Roberta Terranova, Roberto Altieri, Alessandra Nicoletti, Giuseppe Maria Vincenzo Barbagallo, Mario Zappia

Published in: Journal of Neurology | Issue 4/2021

Abstract

Objectives

To evaluate clinical response after external lumbar drainage (ELD) and ventriculoperitoneal shunting (VPS) in a cohort of patients with idiopathic normal pressure hydrocephalus associated with parkinsonism (iNPH-P), considering parkinsonism as clinical primary outcome.

Methods

Patients underwent long-term 72-h intracranial pressure-controlled CSF ELD. Clinical motor response before and after ELD was evaluated using changes in UPDRS-ME as outcome measure. A standardized cognitive assessment was also performed. iNPH-P patients who underwent VPS were clinically followed-up after surgery.

Results

Fourteen iNPH-P patients (age: 69.3 ± 11.6 years) were studied. The time of evaluation after ELD removal was 3.5 ± 1.8 days. We observed a significant motor improvement after the drainage in eight (57.1%) patients. Percent clinical motor response was 18.4 ± 6.7%. Twelve (85.7%) patients underwent VPS. Nine patients were examined after surgery at 31.6 ± 7 months. Four (44.4%) patients presented a clinically detectable improvement in motor response after VPS. No significant changes in cognitive performances were detected.

Conclusions

A clinically detectable motor response on parkinsonian signs was observed in a consistent part of iNPH-P patients few days after ELD as well as over two and half years after VPS. Parkinsonism should be considered as outcome measure for the clinical management of patients with iNPH-P.

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Title: iNPH with parkinsonism: response to lumbar CSF drainage and ventriculoperitoneal shunting
Authors: Giovanni Mostile
Giacomo Portaro
Francesco Certo
Antonina Luca
Roberta Manna
Roberta Terranova
Roberto Altieri
Alessandra Nicoletti
Giuseppe Maria Vincenzo Barbagallo
Mario Zappia
Publication date: 01-04-2021
Publisher: Springer Berlin Heidelberg
Keywords: Hydrocephalus
Hydrocephalus
Hydrocephalus
CSF Drainage
Published in: Journal of Neurology / Issue 4/2021
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-020-10267-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

iNPH with parkinsonism: response to lumbar CSF drainage and ventriculoperitoneal shunting

Abstract

Objectives

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

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