Gait in normal pressure hydrocephalus: characteristics and effects of the CSF tap test

ABSTRACT Normal pressure hydrocephalus (NPH), described by Hakim and Adams in 1965, is characterized by gait apraxia, urinary incontinence, and dementia. It is associated with normal cerebrospinal fluid (CSF) pressure and ventricular dilation that cannot be attributed to cerebral atrophy. Objectives...

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Bibliographic Details
Published in:Arquivos de neuro-psiquiatria 2018-05, Vol.76 (5), p.324-331
Main Authors: Souza, Ricardo Krause Martinez de, Rocha, Samanta Fabrício Blattes da, Martins, Rodrigo Tomazini, Kowacs, Pedro André, Ramina, Ricardo
Format: Article
Language:English
Subjects:
Atrophy
Cerebrospinal fluid
Cognitive ability
Dementia disorders
Gait
hidrocefalia de pressão normal
Hydrocephalus
marcha
NEUROSCIENCES
Pressure
PSYCHIATRY
Statistical analysis
Urinary incontinence
Ventricle
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Summary:ABSTRACT Normal pressure hydrocephalus (NPH), described by Hakim and Adams in 1965, is characterized by gait apraxia, urinary incontinence, and dementia. It is associated with normal cerebrospinal fluid (CSF) pressure and ventricular dilation that cannot be attributed to cerebral atrophy. Objectives: To evaluate gait characteristics in patients with idiopathic NPH and investigate the effect of the CSF tap test (CSF-TT) on gait. Methods: Twenty-five patients diagnosed with probable idiopathic NPH were submitted to the CSF-TT. The procedure aimed to achieve changes in gait parameters. Results: Fifteen gait parameters were assessed before and after the CSF-TT. Five showed a statistically significant improvement (p < 0.05): walking speed (p < 0.001), cadence (p < 0.001), step length (p < 0.001), en bloc turning (p = 0.001), and step height (p = 0.004). Conclusion: This study demonstrated that gait speed was the most responsive parameter to the CSF-TT, followed by cadence, step length, en bloc turning, and step height.
ISSN:0004-282X
1678-4227
1678-4227
DOI:10.1590/0004-282X20180037