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Normal pressure hydrocephalus

MedGen UID:
42526
Concept ID:
C0020258
Disease or Syndrome
Synonyms: Hakim Syndrome; Hakim Syndromes; Hakim's Syndrome; Hakim's Syndromes; Hakims Syndrome; Hydrocephalus, Normal Pressure; Hydrocephalus, Normal-Pressure; Normal Pressure Hydrocephalus; NPH (Normal Pressure Hydrocephalus); NPHs (Normal Pressure Hydrocephalus); Syndrome, Hakim; Syndrome, Hakim's; Syndromes, Hakim; Syndromes, Hakim's
SNOMED CT: NPH - Normal pressure hydrocephalus (30753002); Low pressure hydrocephalus (30753002); Normal pressure hydrocephalus (30753002)
 
Gene (location): CFAP43 (10q25.1)
 
HPO: HP:0002343
Monarch Initiative: MONDO:0009366
OMIM®: 236690
Orphanet: ORPHA314928

Definition

Normal-pressure hydrocephalus-1 (HYDNP1) is an autosomal dominant neurologic disorder characterized by the clinical triad of slowly progressive gait instability, urinary incontinence, and cognitive decline associated with ventricular enlargement on brain imaging with normal pressure of the cerebrospinal fluid (CSF). The onset of symptoms is usually in late adulthood; the symptoms are responsive to shunting. The disorder has been associated with recurrent respiratory infections and possible infertility issues, but the latter has not been confirmed (summary by Takahashi et al., 2011 and Morimoto et al., 2019). [from OMIM]

Clinical features

From HPO
Bowel incontinence
MedGen UID:
41977
Concept ID:
C0015732
Disease or Syndrome
Involuntary fecal soiling in adults and children who have usually already been toilet trained.
Urinary incontinence
MedGen UID:
22579
Concept ID:
C0042024
Finding
Loss of the ability to control the urinary bladder leading to involuntary urination.
Normal pressure hydrocephalus
MedGen UID:
42526
Concept ID:
C0020258
Disease or Syndrome
Normal-pressure hydrocephalus-1 (HYDNP1) is an autosomal dominant neurologic disorder characterized by the clinical triad of slowly progressive gait instability, urinary incontinence, and cognitive decline associated with ventricular enlargement on brain imaging with normal pressure of the cerebrospinal fluid (CSF). The onset of symptoms is usually in late adulthood; the symptoms are responsive to shunting. The disorder has been associated with recurrent respiratory infections and possible infertility issues, but the latter has not been confirmed (summary by Takahashi et al., 2011 and Morimoto et al., 2019).
Dementia
MedGen UID:
99229
Concept ID:
C0497327
Mental or Behavioral Dysfunction
A loss of global cognitive ability of sufficient amount to interfere with normal social or occupational function. Dementia represents a loss of previously present cognitive abilities, generally in adults, and can affect memory, thinking, language, judgment, and behavior.
Global developmental delay
MedGen UID:
107838
Concept ID:
C0557874
Finding
A delay in the achievement of motor or mental milestones in the domains of development of a child, including motor skills, speech and language, cognitive skills, and social and emotional skills. This term should only be used to describe children younger than five years of age.
Gait disturbance
MedGen UID:
107895
Concept ID:
C0575081
Finding
The term gait disturbance can refer to any disruption of the ability to walk.

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVNormal pressure hydrocephalus
Follow this link to review classifications for Normal pressure hydrocephalus in Orphanet.

Conditions with this feature

Normal pressure hydrocephalus
MedGen UID:
42526
Concept ID:
C0020258
Disease or Syndrome
Normal-pressure hydrocephalus-1 (HYDNP1) is an autosomal dominant neurologic disorder characterized by the clinical triad of slowly progressive gait instability, urinary incontinence, and cognitive decline associated with ventricular enlargement on brain imaging with normal pressure of the cerebrospinal fluid (CSF). The onset of symptoms is usually in late adulthood; the symptoms are responsive to shunting. The disorder has been associated with recurrent respiratory infections and possible infertility issues, but the latter has not been confirmed (summary by Takahashi et al., 2011 and Morimoto et al., 2019).
Cockayne syndrome type 2
MedGen UID:
155487
Concept ID:
C0751038
Disease or Syndrome
Cockayne syndrome (referred to as CS in this GeneReview) spans a continuous phenotypic spectrum that includes: CS type I, the "classic" or "moderate" form; CS type II, a more severe form with symptoms present at birth; this form overlaps with cerebrooculofacioskeletal (COFS) syndrome; CS type III, a milder and later-onset form; COFS syndrome, a fetal form of CS. CS type I is characterized by normal prenatal growth with the onset of growth and developmental abnormalities in the first two years. By the time the disease has become fully manifest, height, weight, and head circumference are far below the fifth percentile. Progressive impairment of vision, hearing, and central and peripheral nervous system function leads to severe disability; death typically occurs in the first or second decade. CS type II is characterized by growth failure at birth, with little or no postnatal neurologic development. Congenital cataracts or other structural anomalies of the eye may be present. Affected children have early postnatal contractures of the spine (kyphosis, scoliosis) and joints. Death usually occurs by age five years. CS type III is a phenotype in which major clinical features associated with CS only become apparent after age two years; growth and/or cognition exceeds the expectations for CS type I. COFS syndrome is characterized by very severe prenatal developmental anomalies (arthrogryposis and microphthalmia).
Cockayne syndrome type 1
MedGen UID:
155488
Concept ID:
C0751039
Disease or Syndrome
Cockayne syndrome (referred to as CS in this GeneReview) spans a continuous phenotypic spectrum that includes: CS type I, the "classic" or "moderate" form; CS type II, a more severe form with symptoms present at birth; this form overlaps with cerebrooculofacioskeletal (COFS) syndrome; CS type III, a milder and later-onset form; COFS syndrome, a fetal form of CS. CS type I is characterized by normal prenatal growth with the onset of growth and developmental abnormalities in the first two years. By the time the disease has become fully manifest, height, weight, and head circumference are far below the fifth percentile. Progressive impairment of vision, hearing, and central and peripheral nervous system function leads to severe disability; death typically occurs in the first or second decade. CS type II is characterized by growth failure at birth, with little or no postnatal neurologic development. Congenital cataracts or other structural anomalies of the eye may be present. Affected children have early postnatal contractures of the spine (kyphosis, scoliosis) and joints. Death usually occurs by age five years. CS type III is a phenotype in which major clinical features associated with CS only become apparent after age two years; growth and/or cognition exceeds the expectations for CS type I. COFS syndrome is characterized by very severe prenatal developmental anomalies (arthrogryposis and microphthalmia).
Tremor, hereditary essential, and idiopathic normal pressure hydrocephalus
MedGen UID:
394839
Concept ID:
C2678494
Disease or Syndrome
Congenital myopathy 22A, classic
MedGen UID:
1841089
Concept ID:
C5830453
Disease or Syndrome
Classic congenital myopathy-22A (CMYO22A) is an autosomal recessive muscle disorder characterized by onset of muscle weakness in utero or soon after birth. Early features may include fetal hypokinesia, breech presentation, and polyhydramnios. Affected individuals are born with severe hypotonia and require respiratory and feeding assistance. Those who survive the neonatal period show a 'classic' phenotype of congenital myopathy with delayed motor development, difficulty walking, proximal muscle weakness of the upper and lower limbs, facial and neck muscle weakness, easy fatigability, and mild limb contractures or foot deformities. Some have persistent respiratory insufficiency; dysmorphic facial features may be present (Zaharieva et al., 2016). For a discussion of genetic heterogeneity of congenital myopathy, see CMYO1A (117000).
Lui-Jee-Baron syndrome
MedGen UID:
1849943
Concept ID:
C5882664
Disease or Syndrome
Lui-Jee Baron syndrome (LJBS) is a generalized overgrowth disorder of prenatal onset characterized by extreme tall stature, enlarged liver and spleen, macrocephaly, dysmorphic features, and normal development. Hemizygous males are more severely affected than heterozygous females (Lui et al., 2023).

Professional guidelines

PubMed

Nakajima M, Yamada S, Miyajima M, Ishii K, Kuriyama N, Kazui H, Kanemoto H, Suehiro T, Yoshiyama K, Kameda M, Kajimoto Y, Mase M, Murai H, Kita D, Kimura T, Samejima N, Tokuda T, Kaijima M, Akiba C, Kawamura K, Atsuchi M, Hirata Y, Matsumae M, Sasaki M, Yamashita F, Aoki S, Irie R, Miyake H, Kato T, Mori E, Ishikawa M, Date I, Arai H; research committee of idiopathic normal pressure hydrocephalus
Neurol Med Chir (Tokyo) 2021 Feb 15;61(2):63-97. Epub 2021 Jan 15 doi: 10.2176/nmc.st.2020-0292. PMID: 33455998Free PMC Article
Gavrilov GV, Gaydar BV, Svistov DV, Korovin AE, Samarcev IN, Churilov LP, Tovpeko DV
Psychiatr Danub 2019 Dec;31(Suppl 5):737-744. PMID: 32160166
Shprecher D, Schwalb J, Kurlan R
Curr Neurol Neurosci Rep 2008 Sep;8(5):371-6. doi: 10.1007/s11910-008-0058-2. PMID: 18713572Free PMC Article

Recent clinical studies

Etiology

Passos-Neto CEB, Lopes CCB, Teixeira MS, Studart Neto A, Spera RR
Arq Neuropsiquiatr 2022 May;80(5 Suppl 1):42-52. doi: 10.1590/0004-282X-ANP-2022-S118. PMID: 35976308Free PMC Article
Nakajima M, Yamada S, Miyajima M, Ishii K, Kuriyama N, Kazui H, Kanemoto H, Suehiro T, Yoshiyama K, Kameda M, Kajimoto Y, Mase M, Murai H, Kita D, Kimura T, Samejima N, Tokuda T, Kaijima M, Akiba C, Kawamura K, Atsuchi M, Hirata Y, Matsumae M, Sasaki M, Yamashita F, Aoki S, Irie R, Miyake H, Kato T, Mori E, Ishikawa M, Date I, Arai H; research committee of idiopathic normal pressure hydrocephalus
Neurol Med Chir (Tokyo) 2021 Feb 15;61(2):63-97. Epub 2021 Jan 15 doi: 10.2176/nmc.st.2020-0292. PMID: 33455998Free PMC Article
Wang Z, Zhang Y, Hu F, Ding J, Wang X
CNS Neurosci Ther 2020 Dec;26(12):1230-1240. Epub 2020 Nov 26 doi: 10.1111/cns.13526. PMID: 33242372Free PMC Article
Graff-Radford NR, Jones DT
Continuum (Minneap Minn) 2019 Feb;25(1):165-186. doi: 10.1212/CON.0000000000000689. PMID: 30707192
Williams MA, Malm J
Continuum (Minneap Minn) 2016 Apr;22(2 Dementia):579-99. doi: 10.1212/CON.0000000000000305. PMID: 27042909Free PMC Article

Diagnosis

Carswell C
Pract Neurol 2023 Feb;23(1):15-22. Epub 2022 Sep 26 doi: 10.1136/pn-2021-003291. PMID: 36162853
Skalický P, Mládek A, Vlasák A, De Lacy P, Beneš V, Bradáč O
Neurosurg Rev 2020 Dec;43(6):1451-1464. Epub 2019 Nov 8 doi: 10.1007/s10143-019-01201-5. PMID: 31705404
Gavrilov GV, Gaydar BV, Svistov DV, Korovin AE, Samarcev IN, Churilov LP, Tovpeko DV
Psychiatr Danub 2019 Dec;31(Suppl 5):737-744. PMID: 32160166
Williams MA, Malm J
Continuum (Minneap Minn) 2016 Apr;22(2 Dementia):579-99. doi: 10.1212/CON.0000000000000305. PMID: 27042909Free PMC Article
Relkin N, Marmarou A, Klinge P, Bergsneider M, Black PM
Neurosurgery 2005 Sep;57(3 Suppl):S4-16; discussion ii-v. doi: 10.1227/01.neu.0000168185.29659.c5. PMID: 16160425

Therapy

Deng Z, Wang H, Huang K, Li Y, Ran Y, Chen Y, Zhou L
J Neurol 2023 May;270(5):2724-2733. Epub 2023 Feb 11 doi: 10.1007/s00415-023-11604-6. PMID: 36773060
Nikaido Y, Urakami H, Okada Y, Akisue T, Kawami Y, Ishida N, Kajimoto Y, Saura R
J Neurol 2023 Jan;270(1):357-368. Epub 2022 Sep 7 doi: 10.1007/s00415-022-11362-x. PMID: 36071284
Nakajima M, Yamada S, Miyajima M, Ishii K, Kuriyama N, Kazui H, Kanemoto H, Suehiro T, Yoshiyama K, Kameda M, Kajimoto Y, Mase M, Murai H, Kita D, Kimura T, Samejima N, Tokuda T, Kaijima M, Akiba C, Kawamura K, Atsuchi M, Hirata Y, Matsumae M, Sasaki M, Yamashita F, Aoki S, Irie R, Miyake H, Kato T, Mori E, Ishikawa M, Date I, Arai H; research committee of idiopathic normal pressure hydrocephalus
Neurol Med Chir (Tokyo) 2021 Feb 15;61(2):63-97. Epub 2021 Jan 15 doi: 10.2176/nmc.st.2020-0292. PMID: 33455998Free PMC Article
Ghosh S, Lippa C
Am J Alzheimers Dis Other Demen 2014 Nov;29(7):583-9. Epub 2014 Feb 18 doi: 10.1177/1533317514523485. PMID: 24550545Free PMC Article
Espay AJ, Chen R
Continuum (Minneap Minn) 2013 Oct;19(5 Movement Disorders):1264-86. doi: 10.1212/01.CON.0000436156.54532.1a. PMID: 24092290

Prognosis

Carswell C
Pract Neurol 2023 Feb;23(1):15-22. Epub 2022 Sep 26 doi: 10.1136/pn-2021-003291. PMID: 36162853
Keong NC, Pena A, Price SJ, Czosnyka M, Czosnyka Z, Pickard JD
Neurosurg Focus 2016 Sep;41(3):E11. doi: 10.3171/2016.7.FOCUS16194. PMID: 27581307
Rosseau G
Dis Mon 2011 Oct;57(10):615-24. doi: 10.1016/j.disamonth.2011.08.023. PMID: 22036117
Finney GR
Int Rev Neurobiol 2009;84:263-81. doi: 10.1016/S0074-7742(09)00414-0. PMID: 19501723
Hakim CA, Hakim R, Hakim S
Neurosurg Clin N Am 2001 Oct;12(4):761-73, ix. PMID: 11524297

Clinical prediction guides

Carswell C
Pract Neurol 2023 Feb;23(1):15-22. Epub 2022 Sep 26 doi: 10.1136/pn-2021-003291. PMID: 36162853
Passos-Neto CEB, Lopes CCB, Teixeira MS, Studart Neto A, Spera RR
Arq Neuropsiquiatr 2022 May;80(5 Suppl 1):42-52. doi: 10.1590/0004-282X-ANP-2022-S118. PMID: 35976308Free PMC Article
Keong NC, Pena A, Price SJ, Czosnyka M, Czosnyka Z, Pickard JD
Neurosurg Focus 2016 Sep;41(3):E11. doi: 10.3171/2016.7.FOCUS16194. PMID: 27581307
Ghosh S, Lippa C
Am J Alzheimers Dis Other Demen 2014 Nov;29(7):583-9. Epub 2014 Feb 18 doi: 10.1177/1533317514523485. PMID: 24550545Free PMC Article
Finney GR
Int Rev Neurobiol 2009;84:263-81. doi: 10.1016/S0074-7742(09)00414-0. PMID: 19501723

Recent systematic reviews

Pearce RKB, Gontsarova A, Richardson D, Methley AM, Watt HC, Tsang K, Carswell C
Cochrane Database Syst Rev 2024 Aug 6;8(8):CD014923. doi: 10.1002/14651858.CD014923.pub2. PMID: 39105473Free PMC Article
Aunan-Diop JS, Pedersen CB, Halle B, Jensen U, Munthe S, Harbo F, Johannsson B, Poulsen FR
Neurosurg Rev 2022 Apr;45(2):1157-1169. Epub 2021 Oct 23 doi: 10.1007/s10143-021-01669-0. PMID: 34687356
Martín-Láez R, Caballero-Arzapalo H, López-Menéndez LÁ, Arango-Lasprilla JC, Vázquez-Barquero A
World Neurosurg 2015 Dec;84(6):2002-9. Epub 2015 Jul 14 doi: 10.1016/j.wneu.2015.07.005. PMID: 26183137
Toma AK, Papadopoulos MC, Stapleton S, Kitchen ND, Watkins LD
Acta Neurochir (Wien) 2013 Oct;155(10):1977-80. Epub 2013 Aug 23 doi: 10.1007/s00701-013-1835-5. PMID: 23975646
Esmonde T, Cooke S
Cochrane Database Syst Rev 2002;2002(3):CD003157. doi: 10.1002/14651858.CD003157. PMID: 12137677Free PMC Article

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