Idiopathic Normal Pressure Hydrocephalus With Stuttering: Report of Two Cases and Review of the Literature.
Neurological disorders of aging
Normal pressure hydrocephalus
Stuttering
Ventriculoperitoneal shunt
Journal
World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275
Informations de publication
Date de publication:
Mar 2020
Mar 2020
Historique:
received:
02
10
2019
accepted:
25
11
2019
pubmed:
6
12
2019
medline:
25
3
2020
entrez:
6
12
2019
Statut:
ppublish
Résumé
Idiopathic normal pressure hydrocephalus (iNPH) is a disorder of aging that is characterized by enlarged cerebral ventricles, gait apraxia, dementia, and urinary incontinence. iNPH is frequently misdiagnosed, in part because the symptoms resemble other neurological disorders, and because other associated symptoms have not been fully characterized. Importantly, iNPH has not previously been associated with stuttering, and shunting has not been shown to alleviate the symptom of stuttering. Here, we report 2 cases of patients with iNPH presenting with stuttering that resolved after ventriculoperitoneal (VP) shunt placement. Each patient presented with gait difficulty, incontinence, cognitive impairment, and stuttering. Lasting improvements of the symptoms (including stuttering) were seen in both patients after cerebrospinal fluid (CSF) drainage procedures that included lumbar puncture, extended lumbar CSF drainage, placement of a VP shunt, and VP shunt revision. These findings suggest that iNPH can present with stuttering or dysarthria. The significant improvement in stuttering and dysarthria, along with the improvements in gait difficulty, incontinence, and cognitive impairment that occurred after CSF drainage, suggests that the motor apraxia observed in iNPH can affect speech production. Practitioners should be aware that iNPH can present with stuttering, and that CSF drainage can improve stuttering in select circumstances.
Sections du résumé
BACKGROUND
BACKGROUND
Idiopathic normal pressure hydrocephalus (iNPH) is a disorder of aging that is characterized by enlarged cerebral ventricles, gait apraxia, dementia, and urinary incontinence. iNPH is frequently misdiagnosed, in part because the symptoms resemble other neurological disorders, and because other associated symptoms have not been fully characterized. Importantly, iNPH has not previously been associated with stuttering, and shunting has not been shown to alleviate the symptom of stuttering.
CASE DESCRIPTIONS
METHODS
Here, we report 2 cases of patients with iNPH presenting with stuttering that resolved after ventriculoperitoneal (VP) shunt placement. Each patient presented with gait difficulty, incontinence, cognitive impairment, and stuttering. Lasting improvements of the symptoms (including stuttering) were seen in both patients after cerebrospinal fluid (CSF) drainage procedures that included lumbar puncture, extended lumbar CSF drainage, placement of a VP shunt, and VP shunt revision.
CONCLUSIONS
CONCLUSIONS
These findings suggest that iNPH can present with stuttering or dysarthria. The significant improvement in stuttering and dysarthria, along with the improvements in gait difficulty, incontinence, and cognitive impairment that occurred after CSF drainage, suggests that the motor apraxia observed in iNPH can affect speech production. Practitioners should be aware that iNPH can present with stuttering, and that CSF drainage can improve stuttering in select circumstances.
Identifiants
pubmed: 31805405
pii: S1878-8750(19)33002-5
doi: 10.1016/j.wneu.2019.11.152
pmc: PMC8424911
mid: NIHMS1548802
pii:
doi:
Types de publication
Case Reports
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
176-179Subventions
Organisme : NINDS NIH HHS
ID : R01 NS106985
Pays : United States
Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.
Références
Front Psychol. 2015 Jul 06;6:847
pubmed: 26217245
Neurosurgery. 2001 Nov;49(5):1166-84; discussion 1184-6
pubmed: 11846911
J Fluency Disord. 2003 Winter;28(4):273-95; quiz 295
pubmed: 14643066
Brain. 2008 Nov;131(Pt 11):2904-12
pubmed: 18931387
Acta Neurochir (Wien). 2013 Oct;155(10):1977-80
pubmed: 23975646
Pediatr Neurol. 1996 Sep;15(2):166-8
pubmed: 8888054
J Neural Transm (Vienna). 2008;115(3):443-60
pubmed: 18327532
J Neurosurg. 1997 Nov;87(5):687-93
pubmed: 9347976
Brain. 2004 May;127(Pt 5):947-8
pubmed: 15111447
J Neurol. 2015;262(4):992-1001
pubmed: 25683763