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Here's how to distinguish "sundowning"—agitation or confusion later in the day in dementia patients—from typical aging, from doctors who treat older adults.
This typically causes increased pressure inside the skull. Older people may have headaches, double vision, poor balance, urinary incontinence, personality changes, or mental impairment. In babies, it may be seen as a rapid increase in head size. Other symptoms may include vomiting, sleepiness, seizures, and downward pointing of the eyes. [1]
The underlying etiology of primary NPH has not yet been identified. Primary NPH affects adults age 40 years or older, most commonly in adults over 60. [15] Secondary NPH can affect persons of any age and occurs due to conditions such as subarachnoid hemorrhage, meningitis, brain surgery, brain radiation, or traumatic brain injury. [16]
Elderly people often experience multiple comorbidities that may contribute to the phenomenon of sundowning syndrome through neurodegeneration. Neurological disorders: Alzheimer's disease, Parkinson's disease , Huntington's disease , Lewy body dementia , fronto-temporal dementia, subcortical dementia.
The onset of symptoms is usually within 2 and 3 hours of sleep onset (at the time of transition from slow-wave sleep to a lighter sleep stage) and those events can last from 10 to 30 minutes. Patients generally wake up without any recollection of the event. It is necessary to distinguish confusional arousals in adults from children. [3]
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In children, numerous nonspecific signs and symptoms may be present. [7] The increased pressure leads to compression and traction of the cranial nerves, a group of nerves that arise from the brain stem and supply the face and neck. Most commonly, the abducens nerve (sixth nerve) is involved. This nerve supplies the muscle that pulls the eye ...