Normal Pressure Hydrocephalus in a Known Multiple Sclerosis Patient:
A Rare but Considerable Comorbidity
Mohammad Hossein Harirchian, Nina Javadian and Ghasem
Farahmand*
Iranian Center of Neurological Research, Neuroscience Institute, Imam Khomeini
Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
*Corresponding Author: Ghasem Farahmand, Iranian Center of Neurological
Research, Neuroscience Institute, Imam Khomeini Hospital Complex, Tehran
University of Medical Sciences, Tehran, Iran.
Received:
December 15, 2022; Published: March 09, 2023
Abstract
Multiple sclerosis (MS) is a common chronic neurological disease with pathophysiology consisting of both chronic neuroinflammatory and degenerative process. MS affects people mostly from young age with disabling neurological deficits like impairment memory, gait, psychomotor retardation, and sphincter incontinence. All mentioned symptoms also present as Hakim’s triad in another well-known neurologic disease, i.e., normal pressure hydrocephalus (NPH).
Here, we present a rare case of communicating hydrocephalus in a relapsing-remitting MS patient. The patient admitted with a complaint of gait imbalance and memory problems, which could not be attributed to new MS attack and rather showed a good response to shunting surgery. Further, we focused on concurrency of two diseases NPH and MS in the current literature.
Keywords: Normal Pressure Hydrocephalus; Multiple Sclerosis; Shunt-Responsive Hydrocephalous
References
- Marrie RA., et al. “A systematic review of the incidence and prevalence of comorbidity in multiple sclerosis: overview”. Multiple Sclerosis Journal3 (2015): 263-281.
- Wingerchuk DM., et al. “Multiple sclerosis: current and emerging disease-modifying therapies and treatment strategies”. Mayo Clinic Proceedings (2014).
- HJ Juurlink B. “Is there a pulse wave encephalopathy component to multiple sclerosis?” Current Neurovascular Research2 (2015): 199-209.
- Moreno MJG., et al. “Neuropsychological syndromes in multiple sclerosis”. Psicothema4 (2013): 452-460.
- Murphy AM., et al. “Prevalence of stress urinary incontinence in women with multiple sclerosis”. International Neurourology Journal2 (2012): 86.
- O'Brien T., et al. “Apparent hydrocephalus and chronic multiple sclerosis: a report of two cases”. Clinical and Experimental Neurology 30 (1993): 137-143.
- Algin O., et al. “Unusual patient with multiple sclerosis and shunt-responsive normal-pressure hydrocephalus”. Clinical Neuroradiology1 (2012): 101-104.
- Amaducci L., et al. “Normal" pressure hydrocephalus in chronic inflammatory diseases: a clinical and laboratory study”. Rivista Di Patologia Nervosa E Mentale. 1 (1977): 11-16.
- Romero-Lopez J., et al. “Normotensive hydrocephalus as a manifestation of meningovascular syphilis”. Revista De Neurologia136 (1993): 1543-1545.
- Catananti C., et al. “A case of normal-pressure hydrocephalus associated with rheumatoid arthritis”. Aging Clinical and Experimental Research2 (2010): 189-191.
- Honda K., et al. “Linear deposition of immunoglobulins and complement components on the dura in normal pressure hydrocephalus complicating systemic lupus erythematosus”. Journal of Clinical Neuroscience 5 (2004): 561-563.
- de Oliveira FF., et al. “Normal pressure hydrocephalus in the spectrum of neurological complications of systemic lupus erythematosus”. Neurological Sciences 6 (2013): 1009-1013.
- Scarrow AM., et al. “Communicating hydrocephalus secondary to diffuse meningeal spread of Wegener's granulomatosis: case report and literature review”. Neurosurgery6 (1988): 1470-1473.
- Brean A and Eide P. “Prevalence of probable idiopathic normal pressure hydrocephalus in a Norwegian population”. Acta neurologica Scandinavica1 (2008): 48-53.
- Bateman GA., et al. “A comparison between the pathophysiology of multiple sclerosis and normal pressure hydrocephalus: is pulse wave encephalopathy a component of MS?” Fluids and Barriers of the CNS1 (2016): 18.
- Bateman GA. “Pulse wave encephalopathy: a spectrum hypothesis incorporating Alzheimer’s disease, vascular dementia and normal pressure hydrocephalus”. Medical hypotheses 2 (2004): 182-187.
- Martola J., et al. “Rate of ventricular enlargement in multiple sclerosis: a nine-year magnetic resonance imaging follow-up study”. Acta Radiologica 5 (2008): 570-579.
- Achiron A and Faibel M. “Sandlike appearance of Virchow-Robin spaces in early multiple sclerosis: a novel neuroradiologic marker”. American Journal of Neuroradiology 23 (3 (2002): 376-380.
- ElSankari S., et al. “Concomitant analysis of arterial, venous, and CSF flows using phase-contrast MRI: a quantitative comparison between MS patients and healthy controls”. Journal of Cerebral Blood Flow and Metabolism9 (2013): 1314-1321.
- Czubowicz K., et al. “Levels of selected pro-and anti-inflammatory cytokines in cerebrospinal fluid in patients with hydrocephalus”. Folia Neuropathologica4 (2017): 301-307.
Citation
Copyright