Past Issues

Normal Pressure Hydrocephalus Mimicking Antipsychotic-induced Parkinsonism

Ting-Jen Chen,M.D.1/sup> Wen-Chen Ouyang,M.D.1 Meg Mei-Chih Tseng,M.D.2,3 Ming-Been Lee,M.D.2 Hsi-Chung Chen,M.D.2 

Objective:Normal pressure hydrocephalus (NPH) is a diagnostic challenge for clinicians due to signifi cant variations in its clinical presentation, especially in patients with a psychiatric history. Case Report:A 47-year-old female with chronic schizophrenia had extrapyramidal symptoms (EPS) while being admitted on the psychiatric ward. Her EPS were initially considered to be induced by antipsychotic drugs, but the symptoms persisted despite adjustments in medication. The fi nding of the computed tomographic scan later revealed NPH. After being implanted a ventriculo-peritoneal shunt, her EPS were gradually improved. Conclusion: The typical symptoms of NPH are similar to some of the common mental disorders, or the side effects induced by antipsychotic drugs. NPH is suggested to be considered when schizophrenic patients are presenting a gait or movement disturbance but with poor response to the management for EPS.
Key Word normal pressure hydrocephalus, parkinsonism syndromes
Editorial Committe, Taiwanese Journal of Psychiatry
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