Tations nph may exhibit a classic triad of clinical findings (known as the adams triad or hakim's triad) of urinary incontinence, gait disturbance, and dementia (commonly referred to as "wet, wobbly and wacky" or "weird walking water"). order viagra Gait disturbance is typically the initial and most prominent symptom of the triad and may be progressive, due to expansion of the ventricular system, particularly at the level of the lateral ventricles, leading to traction on the corticospinal motor fibers descending to the lumbosacral spinal cord. viagra women off label use The gait disturbance can be classified as mild (cautious gait or difficulty with tandem gait), marked (evident difficulty walking or considerable unstable gait) or severe (unaided gait not possible) [7] in the early stages, most often this gait disturbance occurs in the form of unsteadiness and impaired balance, especially when encountering stairs and curbs. how long before viagra for daily use works Weakness and tiredness of the legs may also be part of the complaint, although examination discloses no paresis or ataxia. buying viagra online review [8] often a mobility aid is used for added stability, once the patient has reached the mild to marked stage. costo viagra da 5 mg Such aids may include a quad cane or wheeled walker. The patient's gait at the marked stage will often show a decrease in step height and foot-floor clearance, as well as a decrease in walking speed. costo viagra da 5 mg This style is often referred to as a magnetic gait, in which the feet appear to be stuck to the walking surface, and is considered the characteristic gait disturbance of nph. viagra canada online The gait may begin to mimic a parkinsonian gait, with short shuffling steps and stooped, forward-leaning posture, but there is no rigidity or tremor. where can australia order viagra online An increased tendency to fall backwards is also seen, and a broad-based gait may be employed by the patient in order to increase their base of support and thereby their stability. viagra online without prescription In the very late stages, the patient can progress from an inability to walk, to an inability to stand, sit, rise from a chair or turn over in bed; this advanced stage is referred to as "hydrocephalic astasia-abasia" [8] dementia is predominantly frontal lobe in nature and of the subcortical type of dementia. is 200 mg. of viagra ok It presents in the form of apathy, forgetfulness, inertia, inattention, decreased speed of complex information procession (also described as a dullness in thinking and actions), and disturbed manipulation of acquired knowledge, which is reflective of the loss of integrity of the frontal lobes. buy generic viagra online [5] memory problems are usually a component of the overall problem and have been predominant in some cases, which can lead to the misdiagnosis of alzheimer's disease. However, in nph there may be an obvious discrepancy between (often severely) impaired recall and intact or much less impaired recognition. viagra coupon The dementia is thought to result from traction on frontal and limbic fibers that also run in the pe.

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