Facts box Normal pressure hydrocephalus (NPH) presents as a progressive syndrome of gait disturbance, impaired cognition, and loss of bladder control. Noncognitive psychiatric and behavioral manifestations of NPH appear common but have not been systematically studied. A number of reports suggest that NPH can induce schizophrenia-like symptoms, and these appear more likely in cases of secondary NPH. Case reports indicate that when presenting as a manifestation of NPH, psychotic symptoms may improve with appropriate surgical management of NPH. There is potential for delayed recognition of NPH in situations where psychiatric and behavioral symptoms dominate the presentation. The pathogenesis of psychotic symptoms in NPH has not been examined but symptoms are assumed to arise in part from the impact of NPH on fronto-subcortical and basal forebrain networks. Introduction The capacity of normal pressure hydrocephalus (NPH) to induce a reversible dementia syndrome is well known. There is a less well-defined relationship between NPH and schizophrenia-like psychosis. Although evidence supporting a link between the two disorders is limited, available data supports an association. The specificity of the relationship between the two disorders is, however, confounded by the impact of etiological factors intrinsic to NPH itself. These factors may in themselves contribute vulnerability to psychotic disorder, and their effects on brain function cannot be easily separated out from the impact of NPH alone. History of the association The father of medicine, Hippocrates (460-370 BC), first coined the term “hydrocephalus” but believed it to be a manifestation of fluid collection external to the brain.
|Title of host publication||Secondary schizophrenia|
|Editors||Perminder S. Sachdev, Matcheri S. Keshavan|
|Place of Publication||New York|
|Publisher||Cambridge University Press|
|Number of pages||6|
|Publication status||Published - 2010|