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Review
. 2022 Sep;43(9):5201-5205.
doi: 10.1007/s10072-022-06119-3. Epub 2022 Jun 1.

Parkinsonism in idiopathic normal pressure hydrocephalus: is it time for defining a clinical tetrad?

Giovanni Mostile  1   2 , Alfonso Fasano  3   4   5   6 , Mario Zappia  7
Affiliations
Review

Parkinsonism in idiopathic normal pressure hydrocephalus: is it time for defining a clinical tetrad?

Giovanni Mostile et al. Neurol Sci. 2022 Sep.

Abstract

Background: Association between parkinsonism and idiopathic normal pressure hydrocephalus (iNPH) still remains debated. There is already plenty of evidences in the literature suggesting that this clinical sign can be considered as an integral part of the clinical spectrum of iNPH patients.

Methods: We reviewed the possible pitfalls in the core clinical definition of iNPH based on available international diagnostic criteria, phenomenology of parkinsonism in iNPH, and neuroimaging supporting the presence of parkinsonism in iNPH.

Conclusions: We argue that the diagnostic definition of the iNPH "triad" should be possibly reconsidered as a "tetrad" also including parkinsonism.

Keywords: Gait disorders; Idiopathic normal pressure hydrocephalus; Parkinsonism.

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Conflict of interest statement

AF received honoraria from AbbVie, Abbott, Boston Scientific, Ceregate, Ipsen, Integra, Medtronic, and UCB and research support from AbbVie, Boston Scientific, and Medtronic. GM and MZ declare that they have no conflict of interest.

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