Idiopathic Normal Pressure Hydrocephalus Presenting as Psychosis

Area of Science:

• Neurology
• Psychiatry

Background:

• Normal pressure hydrocephalus (NPH) is a neurological syndrome with gait disturbance, dementia, and urinary incontinence.
• Idiopathic NPH (iNPH) presenting primarily as psychosis is an uncommon manifestation.

Observation:

• Three patients diagnosed with psychosis were evaluated for iNPH.
• Psychosis preceded other characteristic iNPH symptoms in all observed cases.
• One patient's psychosis showed a temporal correlation with hydrocephalus onset and resolution via shunting.

Findings:

• Idiopathic normal pressure hydrocephalus (iNPH) was diagnosed in three patients presenting with psychosis.
• Psychosis symptoms improved with hydrocephalus treatment (shunting) in one case.
• Gait apraxia developed years after psychosis onset in two patients.

Implications:

• iNPH should be considered in the differential diagnosis of late-onset secondary psychosis.
• Early recognition and treatment of iNPH may alleviate psychiatric symptoms.
• Further research is warranted to understand the link between iNPH and psychosis.