Q: 57 years old female is admitted to ICU post-shunt for Normal Pressure Hydrocephalous (NPH). Patient gait abnormality is unlikely to improve despite good shunt function?
A) True
B) False
Answer: B
Patients with NPH get very distressed with their gait. It is popularly known as "glue-footed" gait. Other names are magnetic gait, gait apraxia, and frontal ataxia. This gait is characterized by small steps, and with a wide base. This makes the turning difficult. They have to take small steps to turn around. Fall is the biggest risk. "Pull test" can be performed to establish postural instability. Fortunately, gait abnormality is most responsive to shunting.
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#neurosurgery
References:
1. Sudarsky L, Simon S. Gait disorder in late-life hydrocephalus. Arch Neurol 1987; 44:263.
2. Stolze H, Kuhtz-Buschbeck JP, Drücke H, et al. Comparative analysis of the gait disorder of normal pressure hydrocephalus and Parkinson's disease. J Neurol Neurosurg Psychiatry 2001; 70:289.
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