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 exam 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 imbalanced gait, positive Romberg test, and incontinence suggest cerebellar dysfunction. Additionally, the complaint of difficulty thinking straight and the presence of these physical symptoms could indicate normal pressure hydrocephalus. Early dementia is less likely given the normal mental status exam, but cannot be entirely ruled out.

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