Neurological Sciences

, Volume 39, Issue 9, pp 1643–1646 | Cite as

A case of normal pressure hydrocephalus presenting as ventriculoperitoneal shunt-responsive dementia and choreodystonia

  • Dong-Kyu Yeo
  • Jung E. Park
  • Kyum-Yil KwonEmail author
Letter to the Editor

Normal pressure hydrocephalus (NPH) is clinically characterized by progressive gait disturbance, dementia, and urinary incontinence, although the manifestations are known to vary. Features of parkinsonism including freezing of gait have been commonly shown in patients with NPH [1, 2], while chorea or dystonia has rarely been reported [2, 3]. We report a case of an elderly female diagnosed with NPH who presented with dementia and mixed movement disorder phenomenology including chorea and dystonia.

A 68-year-old woman was admitted to our hospital for evaluation of progressive gait difficulty and involuntary movements. The patient’s past medical history was notable for hypertension, diabetes mellitus, a stroke involving the right occipital lobe that occurred 3 years prior to this presentation, and osteoarthritis of bilateral knees. The year prior, she was diagnosed with unspecified dementia at an outside institution and was additionally prescribed an acetylcholinesterase inhibitor. Her...



This work was supported by the Soonchunhyang University Research Fund.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

Additional informed consent was obtained from all individual participants for whom identifying information is included in this article.

Supplementary material

10072_2018_3451_MOESM1_ESM.avi (9.7 mb)
ESM 1 Initial and follow-up videos of the patient. The patient (68-year-old woman) exhibited generalized chorea (neck, right upper extremity, and bilateral lower extremities), cervical dystonia (characterized as laterocollis with some retrocollis), and left upper extremity dystonia. Postural instability was also noted. Three weeks after the ventriculoperitoneal shunt operation, chorea and dystonia were found to be resolved and she was able to walk without assistance with only minimal difficulty, thought to be due to bilateral knee osteoarthritis. (AVI 9974 kb)


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Copyright information

© Springer-Verlag Italia S.r.l., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Neurosurgery, Soonchunhyang University Gumi HospitalSoonchunhyang University School of MedicineGumiRepublic of Korea
  2. 2.Department of Neurology, Dongguk University Ilsan HospitalDongguk University College of MedicineGoyangRepublic of Korea
  3. 3.Department of Neurology, Soonchunhyang University Seoul HospitalSoonchunhyang University School of MedicineSeoulRepublic of Korea

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