Center for Neuroscience Helps Those with Same Illness as Billy Joel

This week Billy Joel canceled his concert tour because of little known medical condition called normal pressure hydrocephalus, or NPH.

The good news for fans of the 76-year-old “Piano Man” singer is that he has no plans to retire and he won’t have to with proper treatment.

And the good news for people who have NPH is that it is treatable.

“At St. Luke’s Center for Neuroscience, we have extensive experience treating normal pressure hydrocephalus (NPH),” said neurosurgeon Craig Goldberg, MD.

NPH is a condition, seen in adulthood, where the fluid that surrounds the brain and the spine, called cerebrospinal fluid (CSF), is unable to drain, but without any increase in pressure on the brain. This can affect hearing, vision and balance.

NPH typically occurs later in life, usually around the age of 70. About 0.2% of people ages 70-80 are diagnosed with it, and that increased to 5.9% for people over the age of 80. People who have had a brain infection, head injury, brain tumor or brain surgery are more at risk for NPH.

There are three main symptoms of NPH, Dr. Goldberg explained:

• Difficulty walking, producing shuffling, wide-based, short steps
• Urinary urgency or even incontinence
• Mild dementia with forgetfulness and difficulty performing routine activities

“Since there are many other potential causes for these symptoms, your care team at St. Luke’s Center for Neuroscience will take a detailed history, perform a thorough physical exam, and ask you specific questions about the symptoms you’ve been having,” he said. “Imaging, typically an MRI of the brain, is performed to rule out other diagnoses. If your symptoms are mild, your St. Luke’s care team may decide to monitor your situation.”

Further workup to help establish the diagnosis typically involves a series of physical and cognitive tests performed before and after a lumbar puncture (spinal tap), which is a procedure that removes cerebrospinal fluid (CSF) from the back.  

Treatment for NPH can be surgical. This usually involves the placement of a drainage tube, called a ventriculoperitoneal shunt, in the fluid-filled spaces inside the brain. 

Early diagnosis and treatment often result in significant improvement in the symptoms of NPH and in quality of life, Dr. Goldberg noted.