Experience with spinal tap to test for NPH

clkspace

I am interested in hearing what other caregivers have experienced when taking their LO for testing for normal pressure hydrocephalus (NPH).  I understand that fluid is removed with a spinal tap (lumbar puncture) and if NPH is the problem a temporary improvement in gait/mobility results.  

I am trying to think through the details for my DW.  Did other people have a PT evaluation performed right before the procedure?  Since my DW could not lay still for an MRI without being anesthetized I assume she would have the same for the spinal tap.  What have others experienced with this?

What happened after the spinal tap?  Was your LO immediately back to their baseline?  For those with a positive NPH indication was the improvement in gait obvious to you or was it hard to tell?  Did you have a PT evaluation afterwards?  How did it go?  How long did the improvement last?

What about those whose LO had a negative NPH indication?  How was that determined?

I appreciate any information to help me decide whether to start down this path.

Cliff

M1

Cliff, an experienced NPH team should be able to tell fairly quickly whether the spinal tap causes improvements in walking and alertness. If it does, they will recommend placement of a shunt to drain the brain ventricles continuously. If it doesn't, they won't place a shunt. You should be able to get a pretty clearcut answer. Good luck.

Kibbee

DH went through testing for NPH.  Immediately prior to the spinal tap he had an evaluation from a physical therapist, who had him do a number of different gait tests.  Then right after recovery from the spinal tap he went back to the physical therapist and did the same gait tests again.  Before the physical therapist even told me, I could tell he had no improvement in his gait from the removal of the spinal fluid / reduction of pressure in the brain. 

He also went on to have a SPECT scan (DaTscan - dopamine transporter scan) to rule in / out Parkinson Disease as the possible cause for his problems with walking and balance.  That also came back as negative.   

I could not be with him during the spinal tap so I don't know how he did with that.  I was allowed to be in the room with him during the SPECT scan.  He was fine for the first half of the test but then became restless and started to move around.  At that time the technician had me go up next to him to hold his hand and keep him calm.