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Bulbar Dysfunction in Idiopathic Normal Pressure Hydrocephalus: A Case Report.

Muhammad Usama1, Avneet Kaur Manjeet Singh Arora2,3, Faraz Saleem4

  • 1Neurology, Sheikh Zayed Medical College/Hospital, Rahim Yar Khan, PAK.

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|March 8, 2023
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Summary

Normal pressure hydrocephalus (NPH) can rarely cause swallowing difficulties. This case report highlights NPH presenting with dysphagia, successfully treated with a ventriculoperitoneal shunt.

Keywords:
bulbarcsfgait ataxianphvp shunt

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Area of Science:

  • Neurology
  • Neurosurgery

Background:

  • Normal pressure hydrocephalus (NPH) is a rare neurological condition characterized by enlarged ventricles and normal cerebrospinal fluid (CSF) pressure.
  • Classic NPH symptoms include cognitive decline, gait disturbance, and urinary incontinence.

Observation:

  • A 75-year-old man presented with choking, dysphagia, ataxia, and memory loss.
  • CT scans revealed ventriculomegaly, confirmed by normal CSF opening pressure via lumbar puncture.

Findings:

  • The patient received a ventriculoperitoneal shunt for NPH.
  • Post-shunting, significant improvement in dysphagia and classic NPH symptoms was observed.

Implications:

  • This case underscores that NPH can manifest with bulbar symptoms like swallowing difficulties.
  • Early recognition and treatment of NPH, even with atypical presentations, can lead to improved patient outcomes.