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Normal Pressure Hydrocephalus (NPH) is a neurological disorder of older adults that is increasing in prevalence and yet often unrecognized. Its symptoms include insidious and progressive difficulties with walking, memory and thinking, and bladder control. With a head CT scan or MRI, enlarged ventricles in the brain are seen. NPH can be a difficult diagnosis to make because its symptoms overlap with those of other common conditions such as Parkinsonism, Alzheimer’s disease and age-related osteoarthritis and bladder dysfunction. However, it is critical to diagnose NPH if present because it is one of the few dementing conditions that can be controlled or reversed with ventricular shunting.
The mission of our integrated program is to provide state-of-the-science diagnosis, treatment and management for patients with NPH. Our program also serves as a base for clinical research to monitor and optimize outcomes, improve methods for diagnosis, evaluate new therapies and theranostics and increase knowledge about NPH.
An initial visit at the NPH Program consists of a comprehensive history and neurological and cognitive exams by a neurology physician and nurse team. Based on the initial impressions, additional diagnostic testing may be recommended including neuroimaging with MRI or PET and cerebrospinal fluid testing. If these tests support a diagnosis of NPH, then surgical treatment with a shunt to normalize cerebrospinal fluid flow may be recommended. Follow-up care and ongoing management of the condition is available.
Accepting New Patients
A new patient’s initial clinic appointment will take about 75 minutes and will consist of reviewing a patient’s medical, neurologic and neuropsychiatric histories, clinical examination, discussion and counseling of the patient’s and family members’ concerns, and development of a follow-up treatment plan. Our clinicians may also order more in-depth tests for the patient that includes blood draws, neuroimaging scans (e.g., PET, MRI, etc...), neuropsychological tests or lumbar puncture procedures.
We do a comprehensive evaluation before your visit. We will intensively screen your record and triage appropriately for a broad evaluation or a more focused visit. It is possible that you will have some testing on the same day of the appointment. We will let you know beforehand.
Since our patients have memory problems or other cognitive concerns, we require our patients to come to their clinic appointments with a close family member or an individual who can provide reliable information about their medical condition.
After the first appointment, our clinicians may order additionaltests and a follow-up visit (known as a résumé visit) to review test results will be scheduled. After the résumé visit, most patients will be seen about every 6 months for follow-up visits.
If available, please bring any pertinent medical records, neuroimaging scans, and an updated list of current medications.
New patients’ initial visits: about 75 minutes Resume visits: about 30 minutes Follow up visits: about 45 minutes
At 79, Tamar wasn’t ready to slow down: She walked three miles a day, was a whiz at Sudoku puzzles, and loved hiking with her husband. But within just a year, she had sharply declined. The once-vibrant septuagenarian could no longer get out of a chair unassisted, didn’t understand how to use a telephone, and had become incontinent. “She was a shell of her former self,” remembers her daughter Iris. “Her physician told us that she had atypical Alzheimer’s disease and that nothing could be done for her.”
Memory Disorders UnitWang Ambulatory Care Center15 Parkman Street 8th FloorSuite 835Boston, MA 02114
New Patient Phone: 855-644-6387Existing Patient Phone: 617-726-1728
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