Normal pressure hydrocephalus: a case report by a physician who is the patient.

This report describes the case of an elderly physician who endured a slowly progressive, ambulatory illness, which was erroneously diagnosed as Parkinson's disease. After ten years of progressive illness the correct diagnosis of normal pressure hydrocephalus (NPH) was finally made, revealing itself, by accident, through incontinence and mild dementia. The patient-physician enjoyed an instantaneous remission induced by a large lumbar puncture (LP) sustained by a ventriculosystemic shunt. The patient-physician dedicated his renewed life to informing the medical profession about this dramatic syndrome, which he believes is more common and more reversible than generally thought. Although the patient had been virtually restored to normal, a series of complications typical of ventriculosystemic shunting (VSS) occurred, including significant hearing loss and subdural haematoma (SDH). The patient feels, however, that his clinical improvement far outweighs the complications and that every patient with NPH should have the opportunity to decide whether or not to have a VSS.