Antipsychotic sensitivity in normal pressure hydrocephalus

Mishra, Biswa Ranjan; Sarkar, Sukanto; Mishra, Sayali; Praharaj, Samir Kumar; Mahapatra, Pranab; Sinha, Vinod Kumar

doi:10.1016/j.genhosppsych.2010.09.014

Cited by 9 publications

(7 citation statements)

References 15 publications

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“…Unusual appearances of NPH symptoms may hinder early diagnosis and consequently proper treatment 5,6,7 . Sometimes, even response to typical treatment in psychiatric syndromes may be impaired, like a described patient having schizophrenia with intolerance to even low dose of antipsychotics, who was subsequently revealed to be having communicating normal pressure hydrocephalus 19,20 . We did not evaluate a control group without NPH in order to compare our findings in idiopathic NPH patients.…”

Section: Discussionmentioning

confidence: 99%

Psychiatric symptoms are present in most of the patients with idiopathic normal pressure hydrocephalus

Oliveira

Rotta

et al. 2014

Arq. Neuro-Psiquiatr.

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Normal pressure hydrocephalus (NPH) is characterized by gait disturbance, dementia and/or urinary incontinence associated with dilation of ventricular system with normal opening cerebrospinal fluid pressure. Wide scientifical evidence confirms association between NPH and psychiatric symptoms. We selected 35 patients with idiopathic normal pressure hydrocephalus from January 2010 to January 2012 in a Brazilian tertiary hospital and performed a formal psychiatric evaluation to identify psychiatric disorders. Psychiatric disorders were present in 71% of these patients, especially anxiety, depression and psychotic syndromes. NPH patients may develop symptoms with frontal dominance, such as personality changes, anxiety, depression, psychotic syndromes, obsessive compulsive disorder, Othello syndrome; shoplifting and mania. Unusual appearances of NPH symptoms may hinder early diagnosis and consequently proper treatment.Keywords: normal pressure hydrocephalus, psychiatry, symptoms. RESUMO A hidrocefalia de pressão normal (HPN) é caracterizada por distúrbios da marcha, demência e/ou incontinência urinária associada com dilatação do sistema ventricular e pressão de abertura do líquido cefalorraquidiano normal. Evidências científicas confirmam associação entre HPN e sintomas psiquiátricos. Foram selecionados 35 pacientes com hidrocefalia de pressão normal idiopática, de janeiro de 2010 a janeiro de 2012 em um hospital terciário brasileiro e realizada uma avaliação psiquiátrica formal para identificar transtornos psiquiátricos. Transtornos psiquiátricos foram detectados em 71% dos pacientes, principalmente depressão, ansiedade e síndromes psicóticas. Pacientes com HPN podem desenvolver sintomas com predomínio frontal, tais como mudanças de personalidade, ansiedade, depressão, síndromes psicóticas, transtorno obsessivo compulsivo, síndrome de Otelo, furtos e mania. Sintomas incomuns de HPN podem dificultar o diagnóstico precoce e o tratamento adequado.Palavras-chave: hidrocefalia de pressão normal, sintomas, psiquiatria.Normal pressure hydrocephalus (NPH) is a syndrome characterized by gait disturbance, dementia and urinary incontinence plus dilation of ventricular system due to disturbance of cerebrospinal fluid (CSF) circulation with normal CSF pressure 1,2,3,4,5,6 . Dilated ventricles theoretically impair perfusion in ventricular walls, generating hypoperfusional states especially in frontal lobes, basal ganglia and thalamus, thus resulting classic symptomatology 7 . NPH can present in two forms: primary (also known as idiopathic), when there are no causative disorders and secondary, where other disorders such as trauma, infection and hemorrhage are putative causes for hydrocephalus 1,2,3,4,5,6 . Idiopathic NPH (INPH) is associated with communicating hydrocephalus (as demonstrated by brain CT or MRI) and CSF pressure within normal range (7-24 cm H2O) 1,2,3,4,5,6 . With improvements in quality of life and subsequent increase in life expectancy, it is expected that a greater number of elderly individuals will suffe...

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Section: Discussionmentioning

confidence: 99%

Psychiatric symptoms are present in most of the patients with idiopathic normal pressure hydrocephalus

Oliveira

Rotta

et al. 2014

Arq. Neuro-Psiquiatr.

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“…To our knowledge, only a few case reports of NPH in patients with schizophrenia are available (Maurizi et al, 1987;Mishra et al, 2011), and there has been no prospective survey regarding iNPH in older patients with schizophrenia. The present study investigated the prevalence and symptoms of iNPH in older patients with schizophrenia.…”

Section: Introductionmentioning

confidence: 99%

Risk of idiopathic normal pressure hydrocephalus in older inpatients with schizophrenia

Yoshino

Yoshida

Mori

et al. 2015

Int. Psychogeriatr.

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The prevalence of possible and probable iNPH in older patients with schizophrenia was much higher than that reported for older people without mental illness. Of the symptoms evaluated with the tests employed, only gait disturbances, particularly walking speed, distinguished schizophrenia patients with iNPH. These findings suggest that we should pay more attention to the possibility of iNPH in older patients with schizophrenia.

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“… 14 The prevalence of psychotic symptoms or SCZ in patients with iNPH has been estimated to be low. 12 , 16 , 20 , 24 …”

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confidence: 99%

Prevalence of Schizophrenia in Idiopathic Normal Pressure Hydrocephalus

et al. 2018

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SCZ seems to occur 3 times more frequently among iNPH patients compared to the general aged population in Finland. The outcome of the treatment was not affected by comorbid SCZ and therefore iNPH patients suffering from comorbid SCZ should not be left untreated. These results merit validation in other populations. In addition, further research towards the potential connection between these chronic conditions is warranted.

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Antipsychotic sensitivity in normal pressure hydrocephalus

Cited by 9 publications

References 15 publications

Psychiatric symptoms are present in most of the patients with idiopathic normal pressure hydrocephalus

Psychiatric symptoms are present in most of the patients with idiopathic normal pressure hydrocephalus

Risk of idiopathic normal pressure hydrocephalus in older inpatients with schizophrenia

Prevalence of Schizophrenia in Idiopathic Normal Pressure Hydrocephalus

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