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Normal pressure hydrocephalus — DGM MCQ

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HardDementiaNormal pressure hydrocephalusDGM

A 78-year-old man has progressive gait disturbance, urinary urgency and cognitive slowing. His gait is broad-based and magnetic. There is no tremor and no hallucinations. Current medicines include amlodipine and metformin. What is the most likely diagnosis?

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Correct answer: C — Normal pressure hydrocephalus

The triad of gait disturbance, urinary symptoms and cognitive decline with magnetic gait suggests normal pressure hydrocephalus. Alzheimer's disease does not usually cause early magnetic gait, Parkinson's disease has bradykinesia and rigidity, depression lacks the gait pattern, and prostate disease alone does not explain cognitive change. Potentially reversible causes of cognitive decline should be recognised and referred.

Reference: NICE NG97; neurology guidance