What to find out about Billy Joel’s mind situation : NPR

Billy Joel canceled the remainder of his summer time live shows and introduced that he has a mind situation referred to as regular strain hydrocephalus.

“I am sincerely sorry to disappoint our viewers, and thanks for understanding,” Joel, 76, advised followers in a put up to social media on Friday.

The situation has brought on issues with Joel’s “listening to, imaginative and prescient and stability,” in response to the assertion, and his docs suggested him in opposition to performing as a result of it has exacerbated these signs. Joel is present process bodily remedy and says he hopes to return to the stage in the future.

The situation is treatable, however underdiagnosed, docs inform NPR.

By going public together with his analysis, the musician may assist others, says Dr. Charles Matouk, vice chair of scientific affairs on the division of neurosurgery at Yale College of Drugs.

“Billy Joel is extremely courageous,” Matouk says. “Extra persons are going to be alerted to this drawback and perhaps get the assistance they want sooner.”

Listed below are three issues to find out about regular strain hydrocephalus (NPH).

1. It occurs when cerebrospinal fluid builds up within the mind

In wholesome individuals, the physique makes about half a liter of cerebrospinal fluid a day, says Dr. Gayatri Devi, director of Park Avenue Neurology in Manhattan. The fluid has a number of capabilities, together with cushioning the mind in opposition to the laborious, bony cranium, transporting vitamins and eradicating waste.

Usually, the fluid will get reabsorbed by giant veins within the head, but it surely does not at all times occur that manner in individuals who have regular strain hydrocephalus.

“What can generally occur is there are some slim bottleneck elements of the system,” Devi says. “And generally in these areas, you’ll be able to have some construct up over time, as we become older, of proteins and different substances and that causes the fluid to again up.”

This “sludge” that causes the buildup is not nicely understood, but it surely is not a part of regular getting old, says Matouk of Yale.

“As a result of your cranium is a closed field, the water wants a manner out or else strain’s going to construct up,” he says.

Regardless of elevated strain on the mind, it is referred to as regular strain hydrocephalus as a result of it occurs so slowly that it stays inside the regular vary, in response to the Cleveland Clinic.

2. Signs are straightforward to overlook

The telltale indicators of regular strain hydrocephalus are issues with strolling, cognitive signs and urinary incontinence. However since sufferers who’ve it are often over 60, they will appear to be regular indicators of getting old.

“All of us have grandmas and grandpas which have bother strolling as a result of they’ve dangerous hips and knees and their again hurts,” Matouk says. “Each women and men, as you become older, are going to begin having bother controlling their bladder. … You are going to have bother together with your reminiscence.”

However when all three occur on the similar time and progressively worsen, that ought to be an indication that one thing shouldn’t be regular.

That stated, it does not at all times occur that manner.

“What makes issues much more sophisticated is individuals do not need to have all three,” Devi says. “They might simply have the urinary drawback. They might simply have the gait drawback. They might simply have the reminiscence drawback.”

What’s extra, generally the motion issues are misdiagnosed as Parkinson’s illness, and the cognitive issues are misdiagnosed as Alzheimer’s. (Although Matouk cautions that Alzheimer’s dementia is completely different from the type of dementia that arises from untreated regular strain hydrocephalus over time.)

As soon as regular strain hydrocephalus is suspected, diagnosing it often includes a CT scan or a mind MRI. Docs who spoke with NPR stated they have not had problem getting insurance coverage to pay for the testing.

Nevertheless, as a result of some radiologists do not know the way to spot it, it may be laborious to get a analysis, says Dr. Ryan Lee, assistant professor of neurosurgery at Vanderbilt College Medical Middle. “It does take some persistence on the a part of the one who ordered the check or the household and the affected person” to verify the pictures are evaluated by a specialist, he says.

The subsequent check is often a lumbar puncture, or spinal faucet, wherein docs insert a needle into the spinal canal to gather some spinal fluid. Then they ask the affected person and their relations if any signs have modified. “We even have the bodily therapist consider earlier than and after,” Lee says, to keep away from any type of placebo impact.

3. It is treatable

To alleviate strain on the mind, docs carry out a surgical procedure that includes drilling a gap into the cranium and inserting a shunt into the mind to empty the surplus fluid to be absorbed by one other a part of the physique — often the stomach.

“As a result of the fluid is getting made repeatedly, you want one thing that repeatedly drains the fluid,” says Devi of Park Avenue Neurology.

Surgical procedure is not for everybody and carries dangers, like an infection, however sufferers can often go residence the following day, she says. The sooner regular strain hydrocephalus is caught and handled, the higher.

The surgical procedure is not a remedy, however “the response will be actually outstanding,” says Lee of Vanderbilt.

“Sufferers can go from being in a wheelchair and never capable of stroll and never capable of suppose very clearly or bear in mind a lot to having the ability to stroll virtually usually and having an enchancment of their cognition and high quality of life considerably,” he says.

Matouk cautioned that cognitive signs have a tendency to enhance much less dramatically than the opposite signs.

Nonetheless, Matouk, who’s learning a new, much less invasive process for these sufferers, hopes consciousness of this situation will assist sufferers advocate for themselves.

“There’s only a few issues in drugs the place we will reverse signs or enhance signs, and it is a illness the place that is doable,” he says. “So, it is a disgrace if it is missed — and it usually is, for months or years, till the right analysis is arrived at.”