The diagnosis and management of idiopathic normal pressure hydrocephalus (NPH) is evolving. However, skepticism about this diagnosis persists among neurologists based upon lack of disease specific pathology, overlap with other neurodegenerative processes, and a lack of uniform diagnostic criteria. Also, prior reports of minimal or transient improvement after treatment with an invasive procedure and lack of high-quality studies has concerned some neurologists. We are joined by 2 experts in the field of movement disorders and CSF flow – Dr. Alberto Espay and Dr. Michael Williams – to discuss advances in our understanding of idiopathic NPH, the PENS trial, and evidence still needed to convince neurologists that NPH is clinical syndrome that warrants timely evaluation and treatment.

• Guest(s): Dr. Alberto Espay, Professor of Neurology at the University of Cincinnati; Dr. Michael Williams, Professor Neurology and Neurological Surgery at the University of Washington
• Interviewer: Dr. Kara Wyant, Clinical Associate Professor of Neurology at the University of Michigan
• Disclosures:
  • Dr. Espay: Consultancies & Scientific Advisory Boards Mitsubishi Tanabe Pharma America (formerly, Neuroderm), Amneal, Acorda, Abbvie, Bial, Supernus (formerly, USWorldMeds), NeuroDiagnostics, Inc (SYNAPS Dx), Intrance Medical Systems, Inc., Merz, Praxis Precision Medicines, Citrus Health, and Herantis Pharma.
  • Dr. Williams: I am a paid consultant to Aesculap regarding devices to treat hydrocephalus
  • Dr. Wyant: Biovie - consulting, (NEW 8/2025) ongoing, UCB Pharma - research support, ended 6/2025, PhotoPharmics - research support, ongoing