A 73-year-old woman with chronic obstructive pulmonary disease, without any other significant medical problems. Her relatives had noticed personality changing in the last few years. At the age of 71 she developed gait disturbance. She felt initially that she was unsteady Abstract Background: The pathogenesis of iNPH is inadequately known. Small vessel disease seems to play an important role but the link to a disturbed CSF dynamic is not described. The familial presentation of idiopathic normal

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... ressure hydrocephalus is extremely rare. Nonetheless, the last years the disclosure of familial occurrence seems to be of interest. The increasing reports on familial iNPH indicate a potential genetic component. Except from iNPH and secondary NPH a third form of NPH, familial NPH, is being widely recognized. Case Presentation: We report iNPH in two adult identical twins. Conclusion: Our case in addition with results from other manuscripts reinforces the suspicion of familial NPH.