Kubo et al developed the idiopathic normal pressure hydrocephalus grading scale (iNPHGS). The authors are from Osaka University, NTT West Osaka Hospital, Nishinomiya Kyoritsu Neurosurgical Hospital and Kitano Hospital in Japan.
Parameters - classic triad of NPH:
(1) cognitive impairment
(2) gait disturbance
(3) urinary disturbance
|
Parameter |
Finding |
Points |
|
cognitive impairment |
normal |
0 |
|
|
complaints of amnesia or inattention but no objective impairment in memory or attention |
1 |
|
|
amnesia or inattention but no disorientation |
2 |
|
|
disoriented to time and place but conversation possible |
3 |
|
|
disoriented to situation or meaningful conversation impossible |
4 |
|
gait disturbance |
normal |
0 |
|
|
dizziness, drift, or difficulty walking (dysbasia) but no objective gait disturbance |
1 |
|
|
unstable but independent gait |
2 |
|
|
walks with a support |
3 |
|
|
walking impossible |
4 |
|
urinary disturbance |
normal |
0 |
|
|
urinary urgency or pollakiuria (frequency) |
1 |
|
|
occasional incontinence |
2 |
|
|
incontinence 1 or more times per day |
3 |
|
|
complete bladder dysfunction |
4 |
iNPHGS =
= SUM(points for all 3 parameters)
Interpretation:
• minimum iNPHGS: 0
• maximum iNPHGS: 12
• The higher the score the more severe the clinical symptoms.
Purpose: To evaluate a patient with idiopathic normal pressure hydrocephalus using the iNPHGS of Kubo et al.
Specialty: Neurology
Objective: severity, prognosis, stage
ICD-10: G91,
