NPH Referring Physician Resources

NPH Clinic Referral

The Henry Ford Multidisciplinary NPH Program provides coordinated care across specialties for optimal evaluation and treatment of patients suspected of having Normal Pressure Hydrocephalus (NPH).

Our primary goal for the NPH clinic is to evaluate patients with enlarged ventricles and the primary symptoms which include:

1. Gait disorder
2. Urinary/Urgency incontinence
3. Cognitive decline

Please keep in mind that many elderly patients with large ventricles do not always have NPH. Approximately 6% of patients with large ventricles are diagnosed with NPH and if they also have a gait disorder, only about 18% of the patients have NPH.

There are currently no drugs or therapy options that are effective in the treatment of NPH, therefore surgery is the only treatment for NPH. Two surgical procedures, shunting (which is most common) and endoscopic third ventriculostomy (ETV), may be beneficial for some patients. In general, walking can improve with these procedures, although memory and urinary incontinence are unlikely to improve.

Please take three to five minutes and fill out the screening tool and return to the NPH Clinic Nurse Coordinator via Fax: (248) 661- 7390 (attn: Toni/Carol) or email to NPHClinic@hfhs.org.

Please complete the screening tool and it will be reviewed within 48 to 72 hours by one of our RNs. Imaging on a CD and outside information will be obtained, and the patient/caregiver will be called. Once the imaging and other outside information is obtained, the patient will be presented at the NPH MDC Conference which is every Wednesday at 1:00 pm. If a NPH Evaluation appointment is recommended, they are 2-3 hours long, which includes Neurological exam, formal cognitive testing, and ambulatory/gait evaluation.

The results of the evaluation will then be reviewed by our multidisciplinary team at the weekly NPH MDC Conference.

The referring physician will receive a copy of the NPH MDC note with the NPH team’s recommendations and any NPH evaluation notes.

We provide all pre-operative, post-operative, and shunt programming care for your patients along with annual NPH clinic evaluations.

NPH MDC Conference is held every Wednesday at 1:00 p.m.

Participants

• Jason Schwalb, M.D., Neurosurgeon
• Pouya Entezami, M.D., Neurosurgeon
• Marina Novikova, D.O., Behavioral Neurologist
• Brent Funk, PhD, Neuropsychologist
• Jennifer Kuc, Nurse Practitioner, Neurology
• Toni Casey, Registered Nurse, Nurse Coordinator
• Carol Paine, Registered Nurse

NPH Clinic Nurse Coordinator
nphclinic@hfhs.org
Phone: (248) 325-0019
Fax: (248) 661-7390

We have also included a list of medications that should be considered as potential contributors to problems with gait, cognition, and urinary/urgency incontinence. Appendix A: Modified Beers List and NPH Pearls (please see below) we have developed for our evaluation of these patients that you may find useful.

Additional Information:

• Modified Beers List (Appendix A)
• NPH Pearls
• The Henry Ford Health NPH Referral Form can be faxed to NPH Clinic Nurse Coordinator via Fax: (248) 661- 7390 (attn: Toni/Carol) or email to NPHClinic@hfhs.org.