Normal pressure hydrocephalus explained as Billy Joel cancels tour dates
What is normal pressure hydrocephalus? The rare brain disorder affecting Billy Joel - and its symptoms, prognosis and treatment
Billy Joel has cancelled his rescheduled concert dates due to a recent brain disorder diagnosis, he has announced on Instagram.
The 76-year-old has said he was recently diagnosed with normal pressure hydrocephalus, a condition that causes a build-up of fluid in the brain.
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The Piano Man singer had been scheduled to play 17 dates across America and the UK, including Murrayfield stadium in Edinburgh on June 6 and Anfield stadium in Liverpool on June 20.
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A post to Joelâs social media said: "Billy Joel has announced that he will be cancelling all scheduled concerts following a recent diagnosis of Normal Pressure Hydrocephalus (NPH).
"This condition has been exacerbated by recent concert performances, leading to problems with hearing, vision and balance.
"Under his doctorâs instructions, Billy is undergoing specific physical therapy and has been advised to refrain from performing during this recovery period.
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"Billy is thankful for the excellent care he is receiving and is fully committed to prioritising his health.
"He is grateful for the support from fans during this time and looks forward to the day when he can once again take the stage."
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Joel said: "Iâm sincerely sorry to disappoint our audience, and thank you for understanding."
Normal pressure hydrocephalus (NPH) is a rare and poorly understood condition that typically affects people over the age of 60, according to the NHS.
It occurs when cerebrospinal fluid (CSF) that surrounds the brain and spinal cord builds up in the brain, disrupting brain function.
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In NPH, this buildup â known as hydrocephalus â is typically gradual enough that the pressure inside the skull increases, but stays within normal range.
"NPH is a type of hydrocephalus that is seen typically in older people," Dr Matthew Potts, associate professor of neurological surgery, radiology and neurology at Northwestern University Feinberg School of Medicine, told The Post.
"The fluid builds up, and it doesnât necessarily affect the pressure in the brain â hence the 'normal pressure' part â but it still affects the brain."
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There are two forms of NPH: primary (idiopathic) NPH and secondary NPH. It is not clear which form Joel has, but primary NPH â attributed to age-related issues â accounts for half of all cases. Secondary NPH is caused by an underlying medical condition that affects the body's CSF.
NPH can cause thinking and reasoning problems, difficulty walking, and loss of bladder control. It can be difficult to diagnose as its symptoms are typically associated with more common conditions such as Alzheimerâs disease.
According to the Alzheimer's Association, the hallmark symptoms of NPH include:
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Difficulty walking â it is sometimes compared to the way a person walks 'on a boat', with the body bent forward and legs held wide apart
Mild dementia â loss of interest in daily activities, forgetfulness and short-term memory problems, and difficulty completing routine tasks
Decline in thinking skills â overall slowing of thought processes, apathy, impaired planning and decision-making, reduced concentration, and personality changes
Loss of bladder control â typically appears later in the disease than difficulty walking and cognitive decline
Normal pressure hydrocephalus is one of the few causes of dementia that can be controlled or reversed with treatment, the Alzheimer's Associations says. However, the longer the condition goes undiagnosed, the more likely the increase in pressure could cause severe brain damage.
Primary NPH is typically treated with surgery and the implementation of a shunt. During this procedure, doctors remove a large amount of CSF and observe the patient for 30 to 60 minutes, looking for any improvements in cognition.
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The type of treatment for secondary NPH depends on the underlying cause.
Experts have not yet found effective nonsurgical treatments for normal pressure hydrocephalus, and more research is needed to fully understand this rare condition.