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What Causes Unimproved Gait After NPH Shunt Placement?
Question: my wife has had an NPH shunt for 3 weeks. Cognitive ability has improved, but gait has shown little improvement and incontenence remains. Can we expect more improvement over time? Is there a time horizon? We have a follow-up with our surgeon in 2 months.
thank you YYYY@YYYY
thank you YYYY@YYYY
Brief Answer:
Read below
Detailed Answer:
I read your question carefully and I understand your concern.
In most patients improvement happens soon after shunt placement, in the first few weeks, so after that time expectations are low I am afraid, improvement often is partial not complete return to previous condition. Generally an idea of the degree expected improvement is obtained by the lumbar puncture with fluid evacuation test which I assume was done before taking the decision to place the shunt.
However that is not clear cut, there are no precise time frames, there are patients who keep improving even in several weeks or months time. Also there is another factor to be considered, the shunt setting. The valves are usually programmable and initially the surgeon chooses a low drainage setting to avoid complications. If that is indeed your case as well, he might choose a higher setting in your follow-up visit which might affect outcome. So it is early to resign yet.
I remain at your disposal for other questions.
Read below
Detailed Answer:
I read your question carefully and I understand your concern.
In most patients improvement happens soon after shunt placement, in the first few weeks, so after that time expectations are low I am afraid, improvement often is partial not complete return to previous condition. Generally an idea of the degree expected improvement is obtained by the lumbar puncture with fluid evacuation test which I assume was done before taking the decision to place the shunt.
However that is not clear cut, there are no precise time frames, there are patients who keep improving even in several weeks or months time. Also there is another factor to be considered, the shunt setting. The valves are usually programmable and initially the surgeon chooses a low drainage setting to avoid complications. If that is indeed your case as well, he might choose a higher setting in your follow-up visit which might affect outcome. So it is early to resign yet.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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