What are the signs and symptoms of normal pressure hydrocephalus (NPH)?

Updated: Jun 04, 2018
  • Author: Stephen L Nelson, Jr, MD, PhD, FAACPDM, FAAN, FAAP; Chief Editor: Jasvinder Chawla, MD, MBA  more...
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Symptoms of normal pressure hydrocephalus (NPH) include the following:

  • Gait disturbance: Usually the first symptom and may precede other symptoms by months or years; magnetic gait is used to emphasize the tendency of the feet to remain "stuck to the floor" despite patients’ best efforts to move them

  • Dementia (of varying degrees): Should be a late finding in pure (shunt-responsive) NPH; presents as an impairment of recent memory or as a "slowing of thinking"; spontaneity and initiative are decreased

  • Urinary incontinence: May present as urgency, frequency, or a diminished awareness of the need to urinate

  • Other symptoms that can occur: Personality changes and Parkinsonism

  • Rarely: Headaches; seizures are extremely rare—consider an alternative diagnosis

See Clinical Presentation for more detail.

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