Brief Answer:
Description of the problem is consistent with NORMAL PRESSURE HYDROCEPHALUS

Detailed Answer:
Good morning. My apologies for your father's less than optimal status but the good news is that your description of what he has is the classic one for a condition known as NORMAL PRESSURE HYDROCEPHALUS. The enlarged ventricles are representative of a fluid overload in the brain which is felt to be due to cortical atrophy (brain substance shrinkage). This is where all the symptoms of forgetfulness, walking/ambulatory problems and other symptoms such as possible urinary incontinence (though you did not mention this as an issue) as well as parkinsonian symptoms emanate. The removal of fluid is usually the test of fire which can clinch the diagnosis. The brevity of effect is also typical for this problem when fluid is taken out. Generally, in a situation such as this- one would consider the surgical placement of a shunt device that can take fluid out of the ventricular system of the brain (where it is causing effects of pressure overload- even though the actual measured pressure in the system is found to be NORMAL- hence the name, NORMAL PRESSURE HYDROCEPHALUS) and pass it into either the peritoneal cavity, the heart, or elsewhere according to the type of patient and discretion of the surgeon. Patients usually do quite well in that setting and with proper cognitive attention can usually regain or establish at least a solid baseline of mental functioning.

Also, ambulation and falls are greatly improved when the shunt is properly installed and operational and many other symptoms of either urinary incontinence, parkinsonisms (Parkinsonian like symptoms), shuffling feet or magnetically moving like feet to the ground in NPH, swallowing difficulties (if present) improve or in some cases disappear.

EEG is a reasonable thing to get since we do know that cortical atrophy (brain shrinkage which is present in this case) can result in abnormal electrical activity. However, my concern in these cases is always the risk of starting antiepileptic medication since it can dramatically reduce cognitive functioning in someone with a compromised baseline status as well as increase falls risks due to added problems of imbalance/dysequilibrium (dizziness). I believe that the change in mental status or even loss of consciousness is more likely due to the effects of the NPH and I would focus attention on resolving this problem as I mentioned by surgical means and hold off on further medications that could compromise his baseline status if the shunt can be placed and implemented in a reasonable amount of time.

Until he is seen in consultation with the surgeon or neurologist he will have to be watched exquisitely for falls and decreasing mental status as fluid buildup will once again occur.

If your question was adequately responded to could you do me the favor of not forgetting to CLOSE THIS QUERY?

I sincerely hope your father starts to feel a bit better sooner rather than later and recommend you speak to your doctor about avoiding increasing risks with additional medications unless florid seizure/epileptic activity is noted. Even if the EEG were positive I would still consider opting for shunt placement and reducing the hydrocephalus as a first measure to see if abnormal electrical activity could be reversed before using aggressive medications which can place him at risk for falls and make cognitive rehabilitation more difficult since these medications also cause reduction in attention, concentration, and memory function.

This query has utilized a total of 19 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

---