A 56-year-old woman brings her 78-year-old father to the emergency room. The patient complains that sometimes he can't think straight. His daughter reports that her father has been tripping over his own feet and has become incontinent of urine in the last few days. The patient's medications include an ACE inhibitor and beta blocker. On physical examination, vital signs are within normal limits, heart and lungs show no abnormalities, cranial nerves are intact, and sensation and muscle strength are normal. A mental status examination is normal. Imbalanced gait and a positive Romberg test are apparent. Which of the following are possible disorders?

Question

Quizplus · Accepted Answer

The patient's symptoms of difficulty thinking, gait imbalance, and urinary incontinence, along with a normal mental status examination and positive Romberg test, suggest normal pressure hydrocephalus (NPH) and could also be indicative of cerebellar dysfunction. Early dementia typically does not present with the acute onset of these specific symptoms, especially not with a normal mental status exam and the described physical findings.

A 56-Year-Old Woman Brings Her 78-Year-Old Father to the Emergency