Normal Pressure Hydrocephalus Case Study

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What does the classic triad of normal pressure hydrocephalus correctly consists of?

A: Gait disturbance, aphasia, dementia
• The reason this is the wrong answer is because aphasia is not consider to be part of the triad in normal pressure hydrocephalus. It is possible for some patient exhibit symptoms of aphasia, agnosia and apraxia which are known as cortical features.
B: Gait disturbance, urinary incontinence, dementia
• Normal Pressure hydrocephalus is a condition caused by enlarged ventricles. Under such conditions there is a normal opening lumbar pressure. This is the correct answer because as the cerebrospinal fluid continues to build up it begins to cause the classic triad of abnormal gait, urinary incontinence and dementia. C:
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female is brought to your neurology clinic by her daughter, who is visiting from California. The patient’s daughter is concerned about her mother’s sleep. She originally thought that her mother just talked in her sleep, but this morning her mother told her that her deceased husband visits her every night and that she talks to him. On examination, you note some rigidity on passive manipulation of the patient’s wrists. Which of the following types of dementia is the patient most likely exhibiting?
A: Alzheimer dementia
• Alzheimer’s disease is a very common disease in elderly patients. Patient’s commonly present with progressive memory loss and other symptoms of decline in cognition. In late stages of this disease the patient may have extrapyramidal dysfunction, such as dystonia and bradykinesia.
• http://emedicine.medscape.com/article/1134817-clinical#b1
B: Dementia with Lewy bodies
• This is the correct answer because patients with this disorder often present with visual hallucinations. This disease can be distinguished from Alzheimer’s by the relatively early extrapyramidal features, anterograde memory loss and the parkinsonian motor

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