Idiopathic Normal Pressure Hydrocephalus: Incidence, Progression, Diagnosis and Treatment

This episode reviews 5 publications on Idiopathic Normal Pressure Hydrocephalus (iNPH), specifically addressing diagnosis, patient selection for shunting, and long-term treatment outcomes. One article is a systematic review and consensus protocol from the International Parkinson and Movement Disorders Society, which addresses the lack of standardization in the large-volume lumbar puncture "tap test," reviewing extensive literature to propose a consistent protocol for volume removal, timing of reassessment, and clinical assessments for gait, cognition, and urination. The second source is a research article discussing long-term shunt responsiveness and the phenomenon of delayed shunt non-responders, presenting detailed clinical data on comorbidities and outcomes in patients categorized as early non-responders, late non-responders, and full responders to ventriculoperitoneal shunt surgery. All articles aim to refine clinical practice and future research efforts related to the diagnosis and management of iNPH. One article is a very recent clinical trial providing evidence for the benefit of shunting to improve gait in these patients.