Billy Joel & Normal Pressure Hydrocephalus (NPH)
- Connie Bonis-Smith, OTR/L
- Jun 6
- 3 min read
You may have seen in the news that the famous singer, songwriter, and piano man extraordinaire (can you tell I'm a fan?), Billy Joel, shared his recent diagnosis of Normal Pressure Hydrocephalus (NPH) with the public. He is not alone, and while rare, NPH is often misdiagnosed because it mimics symptoms of other neurological diseases, such as Parkinson's Disease or Dementia. The critical difference between NPH and many other neurological conditions is that symptoms of NPH can be reversed and, if diagnosed early, there is a significantly higher likelihood of improvement.
Understanding NPH
Normal Pressure Hydrocephalus (NPH) is a condition that affects the brain and can cause problems with walking, thinking, and bladder control. It happens when there is too much cerebrospinal fluid (CSF)—a clear fluid that cushions and protects your brain and spinal cord—inside the brain. Normally, this fluid flows in and out of the brain, maintaining just the right balance, but in NPH, this process gets disrupted.
Who does it affect?
NPH is more common in older adults, typically over the age of 60. It is described as being either "idiopathic" with no known cause or secondary to a known medical condition, such as a head injury or infection.
What are the symptoms?
Not the clinical description (obviously), but an easy way to make sense of the common symptoms of NPH is by the phrase, "wet, wacky, and wobbly":
Wet: Loss of bladder control, leading to frequent urination or even incontinence.
Wacky: Memory problems, confusion, or difficulty reasoning, which can resemble dementia.
Wobbly: Trouble walking, often described as a shuffling or unsteady gait.
How is it treated?
The standard treatment for normal pressure hydrocephalus is a surgical procedure to place a shunt in the ventricles of the brain and connect this drain to the abdomen. The shunt, known as a VP shunt, provides an alternative drainage pathway for the built-up fluid. Research shows that symptoms improve in about 50% to 90% of patients who have a CSF shunt surgically implanted, and outcomes tend to be best for those who receive treatment early in the course of the disease.
With or without shunt placement, be sure to speak to your doctor about starting Physical, Occupational, and Speech Therapy services. You want to bring the experts to your team who can help maximize your recovery and function from being wet, wacky, and wobbly! With therapy, you can expect:
Mobility Improvements
Gait training to improve walking patterns.
Balance exercises to help prevent falls.
Strength training to enhance overall physical condition
Fall Prevention Strategies
Modifying the home environment to reduce hazards.
Teaching safe transfer techniques.
Providing assistive devices when necessary.
Daily Living Activities
Adaptive techniques for proper body mechanics.
Assistive devices to simplify tasks.
Cognitive strategies to enhance memory and task management.
Cognitive Rehabilitation
Cognitive decline is a significant concern for many patients with NPH. Cognitive rehabilitation is provided by occupational therapists and speech-language therapists, who will structure a program of exercises and activities to bolster cognitive skills.
Learn More
If you would like more information on hydrocephalus, please visit the Hydrocephalus Association and speak to your doctor if you have concerns for you or a loved one.
You can learn more about the role of therapy and how LifeCare can help by calling LifeCare or sending us a message. We are here to help.
And lastly.... for Billy Joel... keep, "Keeping the Faith". Your fans worldwide wish you a speedy recovery.
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