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Parkinsons Imposter

Rare neurological disorder is often misdiagnosed as Parkinson's Disease-->
By: Ray Doughty
Updated: June 12, 2012
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A Bedford, Indiana man lived for years with a misdiagnosed condition, but now he's grateful that his doctors were able to figure it out.

NPH, or Normal Pressure Hydrocephalus, has symptoms that are similar to Alzheimer's and Parkinson's Disease.

When 70-year-old JD Cain began showing those symptoms, he was mistakenly diagnosed with Parkinson's.

Just months ago, Cain had limited capabilities.

Now he's stone cutting and fishing for fun.

"It is dramatic. I lay in here six and a half hours one day and couldn't get up. I fell down the stairs," he said.

His wife Donna says cognitively and with incontinence, JD was different too.

"It was like taking care of a baby again," said Donna. "He was slow thinking."

"I always questioned Parkinson's because JD did not have a tremor," she added. 

She was right, and pushed for second opinions.

Eventually JD was referred to Indiana University Health neurosurgeon Dr. Michael Turner.

Turner says JD presented with a classic exam for NPH.

"One of the first things we will notice is that the patient can't get out of the chair. Once they get out, they can't initiate the walk. They shuffle," said Dr. Turner.

Turner says JD's MRI confirmed the diagnosis.

JD had extra spinal fluid space and extra pressure in his brain that disturbs his brain function.

The images, coupled with a triad of symptoms, help doctors make the diagnosis, but often it's missed and attributed to aging, Parkinson's or Alzheimer's.

"Old people do have walking issues. They do have dementia and bladder issues," said Turner.

For NPH, look for trouble walking, mild dementia and impaired bladder control.

For many patients like JD, Dr. Turner says there is a surgical fix.

In November, he placed a shunt in JD's brain.

It's attached to a catheter and drains excess spinal fluid to the abdominal cavity.

Now JD's shuffle is gone.

He can walk to his pond to fish.

"I didn't believe he would change so much," said Donna. "If we hadn't changed doctors he would've never been diagnosed."

"Thanks to God, thanks to Dr. Turner, I have my life back," said JD.

It's amazing that for 15 years he took Parkinson's medicine, invested in nine pills a day and even wore diapers due to incontinence.

It was humiliating, expensive and the wrong diagnosis.

If the classic symptoms of problems walking, dementia and incontinence are familiar, it's worth asking: could it be NPH? 

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