Objective: Idiopathic Parkinson’s disease (PD) and Normal pressure hydrocephalus (NPH) can have similar clinical presentation. However, diagnostic precision is important as clinical management differs. Previous reports have shown same patient having PD and NPH. In this study, we report for the first time, two siblings with long standing Parkinsonism, one diagnosed with PD and other with NPH

Background: Idiopathic Parkinson’s disease (PD) is a chronic neurodegenerative disorder characterized by rest tremor, rigidity, bradykinesia and postural instability, with slow progression of symptoms over years. On the other hand, Normal pressure Hydrocephalus is an acquired condition, characterised by gait impairment, cognitive decline, urinary symptoms, venticulomegaly and normal CSF pressure. Previous authors have described patients with concomitant PD and NPH [10]. However, to the best of our knowledge, siblings with NPH in one and PD in the other have not been described till date.

Method: We report two siblings with long standing Parkinsonism, one diagnosed with Idiopathic PD and underwent Deep brain stimulation after 28 years of illness, while the other was diagnosed with NPH and underwent Ventriculoperitoneal shunt 13 years after her initial symptoms of Parkinsonism

Results: we report for the first time, two siblings with long standing Parkinsonism, one diagnosed with PD and other with NPH. Both underwent surgical treatment with good clinical outcomes. Genetic testing revealed abnormality in DMNT1 gene in both. Clinical and radiological features and the importance of approaching patients with an open mind is discussed.

Conclusion: In conclusion, clinicians should be aware that phenotypic similarities in the illnesses of siblings need not mean that they suffer from the same disease. Also, any sudden deterioration or clinical worsening should prompt us to search for other coexisting illness

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MDS Abstracts - https://www.mdsabstracts.org/abstract/idiopathic-parkinsons-disease-and-normal-pressure-hydrocephalus-a-tale-of-two-sisters/