New onset psychosis with idiopathic normal pressure hydrocephalus

Idiopathic normal pressure hydrocephalus (INPH) may present with psychotic symptoms even before gait disturbance, urinary dysfunction, and cognitive impairment. A case of a 22 years-old male with INPH responded to Risperidone 2mg twice daily for paranoid delusions without neurological intervention. Ten Similar cases of INPH were identified in the literature by Medline search between 1996 and 2015 who presented with major psychiatric symptoms before clinical triad of INPH. INPH may initially present with major psychiatric symptoms than neurological symptoms. Further clinical trials are needed to investigate if early treatment of INPH aborts psychiatric symptoms.