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q13. 72yo man w/ difficulty walking, urin incontin - monicab
#4
E) Failure to inhibit the voiding reflex

Normal Pressure Hydrocephalus

The classic clinical triad of normal pressure hydrocephalus (NPH) is
Dementia, Gait apraxia, and Urinary incontinence.

Urinary incontinence appears late in the illness, and is found to be of the spastic hyperreflexic, increased-urgency type associated with decreased inhibition of voiding reflex, there is a lack of concern for micturition due to the severe frontal lobe cognitive impairment. This is also known as "frontal lobe incontinence", where the patient becomes indifferent to their recurrent urinary symptoms
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