Decrease of excessive daytime sleepiness after shunt treatment for normal pressure hydrocephalus.
Simon Lid��n, Anna Lindam, Dan Farahmand, Anne-Marie Landtblom, Katarina Laurell
Author Information
Simon Lid��n: Department of Biomedical and Clinical Sciences, Neurology, Link��ping University, Link��ping, Sweden. ORCID
Anna Lindam: Department of Public Health and Clinical Medicine, Unit of Research, Education and Development - ��stersund, Ume�� University, Ume��, Sweden.
Dan Farahmand: Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Anne-Marie Landtblom: Department of Biomedical and Clinical Sciences, Neurology, Link��ping University, Link��ping, Sweden.
Katarina Laurell: Department of Biomedical and Clinical Sciences, Neurology, Link��ping University, Link��ping, Sweden.
sleepiness and apathy are often reported in patients with normal pressure hydrocephalus. However, research on outcomes after shunt surgery has mainly focused on the classical triad symptoms, that is, gait, cognition, and bladder dysfunction. This study aimed to describe the effects of shunt treatment on excessive daytime sleepiness and whether there was a relation to changes in ventricular volume. Pre- and postsurgical excessive daytime sleepiness was investigated using the Epworthsleepiness scale in a sample of 32 patients with normal pressure hydrocephalus who underwent shunt surgery. Data were gathered before surgery and at 1, 2, and 3���months after surgery and with different settings of the shunt. In the total sample, the Epworthsleepiness scale improved by a median of 1.5 points at 1���month after surgery, p���=���0.026. The improvement was predominately found in the group (n���=���6) with high presurgical daytime sleepiness (Epworthsleepiness scale >12) (median���=���12 points, p���=���0.035) compared with a median change of 0 points (p���=���0.47) in the group with Epworthsleepiness scale ���12 (n���=���26). Between the postsurgical follow-ups, no further change in the Epworthsleepiness scale score was observed. The Epworthsleepiness scale score did not correlate with clinical tests nor with ventricular volume. Daytime sleepiness seems to be another domain of normal pressure hydrocephalus symptomatology in addition to the classical triad that is responsive to treatment, at least when pronounced. The Epworthsleepiness scale is a quick test to administer and could be a valuable addition to pre-surgical screening for treatable symptoms.
