Rockville woman finds balance with brain disorder diagnosis -- Gazette.Net


Sheila Poms knew her trouble walking wasn’t just because she was getting older.

“I kept falling all the time,” she said. “I would get out of the car and fall down, and I would be walking and I would fall.”

Poms, 78, of Rockville, started having trouble walking a few years ago. She went to her doctor, who referred her to a neurologist.

At first, the neurologist thought Poms’ symptoms might be caused by Parkinson’s disease. When her condition didn’t respond to treatment, he sent her to Sinai Hospital in Baltimore to get tested for normal pressure hydrocephalus, or NPH, a buildup of fluid in the brain that affects seniors.

Amanda Garzón, communications and marketing manager for the Bethesda-based Hydrocephalus Association, said trouble walking is one of the biggest telltale signs of NPH.

“Individuals describe it as feeling that their feet have magnets that are stuck to the ground,” said Poms, who is retired after managing a medical practice.

Patients have trouble picking up their feet and taking steps to turn around, so they often fall, she said. The other typical symptoms are mild dementia and impairment in bladder control.

Garzón said the association estimates that about 375,000 senior citizens in the United States are living with NPH, although more may be undiagnosed. Some researchers believe that up to 5 percent of dementia patients actually have NPH.

Dr. Michael A. Williams, medical director of The Sandra and Malcolm Berman Brain & Spine Institute at LifeBridge Health, treated Poms at Sinai Hospital. He said NPH is often misdiagnosed or overlooked because people think the symptoms are due to aging.

Williams said that trouble thinking, problems with balance and bladder control problems are the three most common problems in elderly patients, and each symptom on its own has a long list of potential explanations.

“People and their families sometimes say, ‘Well, Mom’s 70. That’s the way it’s supposed to be,’” Williams said.

Put together, however, the symptoms may indicate NPH, he said.

For Poms, Williams recommended shunt surgery. Doctors placed a shunt, a small tube-like device, in her brain. The shunt allowed excess cerebrospinal fluid to drain from her brain and be absorbed into her body.

Poms said the surgery and an exercise regimen to strengthen her legs have helped her considerably.

“I do work out three days a week, and that has made my legs so much stronger,” Poms said. “... But I think that the shunt has made a big difference. At least, it has with my children. They keep saying to me, ‘Oh, you’re doing so much better than you were before.’”