Craniosacral Therapy Use in Normal Pressure Hydrocephalus

Nearly 700,000 adults in the US have normal pressure hydrocephalus (NPH), but it is often misdiagnosed as Alzheimer’s or Parkinson’s disease. In fact, a small percentage of people with the disease are properly diagnosed. NPH presents classically with a triad of symptoms: ataxic gait, dementia, and urinary incontinence. Diagnosis and treatment are provided together through a lumbar puncture. However, the only effective treatment that exists is a shunt insertion, which is a highly invasive procedure with uncertain responsiveness. As NPH is primarily diagnosed in those in advanced ages (60s and 70s), adjunctive treatment modalities should be further studied. Here we present a case of a patient diagnosed by a neurosurgeon and neurologist with NPH and a candidate for a shunt insertion whose symptoms substantially improved with one month of osteopathic manipulative treatment. Osteopathic considerations and literature are also reviewed in the broader context of craniosacral treatment.