He made generations dance, but he could no longer occur on stage. At 75, Billy Joel has just canceled several concerts scheduled for the coming weeks, for medical reasons. The announcement, fallen at the end of May, surprised his fans: the artist actually suffers from hydrocephalus with normal pressure, a rare and often overlooked neurological condition.
A cognitive degradation that puts the artist to stop
The news was confirmed by the Langone hospital medical team at New York University, where the singer is followed. Its neurologist, Dr. Neil Patrick Holland, explains that this form of hydrocephalus can affect memory, the approach, and even cause a loss of control of certain motor functions. In Billy Joel, the first symptoms have manifested themselves by balance disorders and a slow cognitive degradation, marked enough to justify immediate care … and the cessation of his concerts.
A brain disease often confused with Alzheimer’s
Hydrocephaly with normal pressure (HPN) results from an excessive accumulation of cerebrospinal fluid in the ventricles of the brain, without an increase in apparent pressure. Professor Marc Verny, geriatrician and specialist in this pathology, specified in a previous article: “We distinguish secondary HPNs (to meningitis, head trauma or surgery) and idiopathic HPNs, whose cause is not known“. This last form, linked to aging, mainly affects the elderly.
The prevalence remains unclear, due to the lack of reliable epidemiological studies, but it would concern between 0.5 and 1 % of the over 60s – around 100,000 people in France. The greatest risk: “Its sub-diagnosis leads to a loss of chance for patients, while management is possible“, Alerted Professor Verny.
Signs that must alert
Three main symptoms define HPN, what doctors call the Hakim and Adams triad:
- Walking disorders, with postural instability, slowing down and a feeling of “glued to the ground”;
- Cognitive disorders, close to those observed in Alzheimer’s disease: loss of attention, memory disorders, unsuitable behavior;
- Urinary incontinence, often by imperiality.
“”The problem is that many pathologies can manifest themselves in these symptoms ”, Recalls Professor Verny. This makes the diagnosis complex, especially since Alzheimer and HPN can coexist. “Both are not always in opposition, but sometimes associated“He explains.
The use of medical imaging is essential, but is not enough. “”The trap to avoid is to evoke the diagnosis only on a scanner or an MRI. We treat a patient, not an image“Insists the professor.
Pending artistic consequences
The Billy Joel’s health team evokes a possible protocol, in particular via a subtractive lumbar puncture aimed at reducing the pressure of the cerebral fluid. However, it is a transitional treatment, which does not heal the disease.
In some cases, surgery with implantation of a ventricular shunt makes it possible to significantly improve motor and cognitive functions. For the moment, no ad has been made on a possible date of recovery of the concerts. “”Billy’s health is our absolute priority“Said his representatives.