Hydrocephalic Parkinsonism: lessons from normal pressure hydrocephalus mimics.
Hydrocephalic Parkinsonism: lessons from normal pressure hydrocephalus mimics.
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DOI：
10.1186/2054-7072-1-2
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发表时间：
2014
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影响因子：
--
通讯作者：
Espay AJ
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文献类型：
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作者：
Starr BW;Hagen MC;Espay AJ
脑积水是进行性核上性麻痹 (PSP) 和路易体痴呆 (DLB) 的一种未被充分认识的表现。我们描述了经病理证实的 PSP (n = 3) 和 DLB (n = 1) 的四种正常压力脑积水 (NPH) 样表现，并回顾了有关这些非典型帕金森病脑积水表现的文献。尽管存在与脑实质萎缩程度不成比例的脑室扩大，但所有患者均表现出早期姿势障碍和/或动眼神经异常，这鼓励了诊断修正。幻觉是脑积水 DLB 表现的唯一早期非典型表现。早期姿势障碍、跌倒、动眼神经障碍和/或幻觉与 NPH 的诊断不一致，提示 PSP 或 DLB 作为潜在的 NPH 模拟。我们假设先前报道的“双重”病理病例（例如 NPH 和 PSP）实际上代表了选定的神经退行性疾病的脑积水表现。本文的在线版本 (doi:10.1186/2054-7072-1-2) 包含补充材料，可供授权用户使用。
Hydrocephalus is an under-recognized presentation of progressive supranuclear palsy (PSP) and dementia with Lewy bodies (DLB). We describe four normal pressure hydrocephalus (NPH)-like presentations of pathology-proven PSP (n = 3) and DLB (n = 1) and review the literature on the hydrocephalic presentation of these atypical parkinsonisms. Despite the presence of ventriculomegaly disproportionate to the extent of parenchymal atrophy, all patients demonstrated early postural impairment and/or oculomotor abnormalities that encouraged a diagnostic revision. Hallucinations were the only early atypical manifestation of the hydrocephalic DLB presentation. Early postural impairment, falls, oculomotor impairment, and/or hallucinations are inconsistent with the diagnosis of NPH and suggest PSP or DLB as the underlying NPH mimic. We postulate that previously reported cases of “dual” pathology (e.g., NPH and PSP) actually represent the hydrocephalic presentation of selected neurodegenerative disorders. The online version of this article (doi:10.1186/2054-7072-1-2) contains supplementary material, which is available to authorized users.