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iNPH with parkinsonism: response to lumbar CSF drainage and ventriculoperitoneal shunting
- Source :
- Journal of neurology. 268(4)
- Publication Year :
- 2020
-
Abstract
- 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. 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. 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. 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.
- Subjects :
- medicine.medical_specialty
Neurology
Ventriculoperitoneal shunting
Parkinsonism
Ventriculoperitoneal Shunt
03 medical and health sciences
0302 clinical medicine
Lumbar
Parkinsonian Disorders
Normal pressure hydrocephalus
Cerebrospinal Fluid Pressure
Medicine
Humans
030212 general & internal medicine
Neuroradiology
Aged
Aged, 80 and over
business.industry
Csf drainage
Middle Aged
medicine.disease
Hydrocephalus, Normal Pressure
Surgery
Cohort
External lumbar drainage
Drainage
Neurology (clinical)
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 14321459
- Volume :
- 268
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Journal of neurology
- Accession number :
- edsair.doi.dedup.....ec6b2fe0ef20247016b796b7d63e3442