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An Imposter Disease

It Looks Like Alzheimer’s or Parkinson’s Disease, but Is It?

Mysterious condition is often misdiagnosed

In the weeks after he fell and smacked his head, Edgar Eckermann went downhill fast. His family watched with alarm as the retired veterinarian’s sense of humor and sharp memory evaporated. His daily exercise regimen, befitting the 30 years he spent as an Army officer, was replaced by a slow, shuffling gait. Unable to balance a checkbook, he also lost the ability to write.

Doctors knew that Eckermann had suffered a skull fracture and concussion. But numerous tests failed to show a conclusive reason for the rapid deterioration that pervaded all aspects of his life.

Eckermann and his wife, Ginger, were terrified he was showing signs of dementia, particularly of Alzheimer’s disease.

“He was probably more worried about Alzheimer’s than anything,” recalls the couple’s daughter, Christine Eckermann-Ross.

Today, more than two years after hitting his head, Eckermann shows few signs of the ordeal. He works crossword puzzles, has resumed handling the family finances, walks more than a mile each day and regularly works out at a gym. The man who once passed his days sitting in the living room of his Greenville, N.C., home recently returned from a trip to the Galapagos Islands with his wife.

“It was just amazing,” says Eckermann, who is 80 years old.

His remarkable turnaround is the result of successful treatment last year for a condition frequently misdiagnosed as Parkinson’s disease or Alzheimer’s disease, both of which have similar symptoms, according to Richmond, Va., neurosurgeon Harold F. Young. The condition “is really worth looking for, especially if Parkinson’s or dementia have been diagnosed,” he says. “A lot of patients are also on a lot of medications and that’s the other thing you have to sort out.”

Eckermann’s problem began in February 2007, after he fell backward down several stairs while carrying a package and hit his head on the driveway. He managed to come into his house and call his wife who sped home from her job at a nearby bridal shop.

An ambulance took him to a nearby emergency room, where doctors determined he had been spared a more serious head injury such as a brain bleed or blood clot. Subsequent tests also ruled out a heart attack or stroke.

But within a week Eckermann was showing signs of additional problems. He began falling for no apparent reason. Walking became increasingly difficult, and his brisk gait morphed into a tentative shuffle.

Cognitive and behavioral changes came next. His easygoing personality was replaced by a humorless snappishness as Eckermann struggled to express himself. “He knew what he wanted to say but couldn’t say it,” says Christine Eckermann-Ross, a veterinarian who lives near her parents.

Within months his wife had taken over the family finances and arranged for the remodeling of two bathrooms to accommodate a wheelchair. She steeled herself for life with a husband who could never be left alone. “I was preparing for the worst,” she says.

“It was a tremendous strain on my mother,” recalls Eckermann-Ross.

Ginger Eckermann says the couple shuttled between their home and various doctors’ offices. “Doctors would say it’s not Alzheimer’s and it’s not Parkinson’s,” she recalled. “Ed was getting worse and worse. They really didn’t have much to tell us.”

Doctors weren’t sure whether some of Eckermann’s problems might be caused by the many medications he was taking to treat his high blood pressure, heart problems and other ailments.

In January 2008 Ginger took her husband to the neurologist for a regular appointment. This time she was armed with a new MRI scan of her husband’s brain, the first such test in months.

The doctor took one look at it and told her, “I have a diagnosis. It’s NPH.”

“What’s that?” she asked.

NPH, short for normal pressure hydrocephalus, is a buildup of cerebrospinal fluid in the brain. First described by neurosurgeons in 1965, the condition can occur after a stroke or a head injury from a fall, although its cause is often unknown. It is common, according to the National Institute of Neurological Disorders and Stroke (NINDS), for NPH to be misdiagnosed—or diagnosed too late for effective treatment.

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