Billy Joel canceled his summer concert tour Friday after being diagnosed with normal pressure hydrocephalus, a rare but non-fatal brain issue caused by fluid buildup.
The "Piano Man" singer said in an Instagram post that he has issues with hearing, vision and balance, which are made worse by performing. Joel, 76, is undergoing physical therapy and was advised by his doctor to cancel the tour while he recovers.
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Joel said he is grateful for the care he is receiving and committed to prioritizing his health. However, it is not a permanent hiatus. He said he looks forward to taking the stage again.
"I'm sincerely sorry to disappoint our audience, and thank you for understanding," Joel wrote.
In February, the musician made headlines when he stumbled onstage during a concert. Stumbling is among the symptoms of normal pressure hydrocephalus. In April, he postponed shows to undergo surgery and physical therapy for an unnamed medical condition. He planned to resume his tour July 5 in Pittsburgh before this latest announcement.
Joel wasn't scheduled to play in Philadelphia, but he canceled shows in nearby New York City and Washington.
What is normal pressure hydrocephalus?
Normal pressure hydrocephalus is caused by a buildup of fluid in chambers of the brain called ventricles. The body typically makes and absorbs the same amount of this fluid each day to cushion the brain and spinal cord. A buildup can be caused by a block in the brain or the spinal cord from an injury, infection or other issue. This causes the ventricles to enlarge and press against brain tissue, which can damage the brain.
There are two types of normal pressure hydrocephalus: primary and secondary. A primary diagnosis means it does not appear to be caused by a different medical condition, while secondary means it can be attributed to a separate underlying condition such as a brain aneurysm.
According to the Cleveland Clinic, research shows it might be caused by degenerative brain conditions such as dementia and Alzheimer's disease. However, little is known about the root cause of normal pressure hydrocephalus.
Who is most at risk and what are the symptoms?
Normal pressure hydrocephalus primarily occurs in people over 65, although it is rare overall. The Cleveland Clinic estimates that about 0.2% of people ages 70-80 and 5.9% of people over 80 have been affected by the condition worldwide. It only affects about 0.0003% of people under 65.
Symptoms can include trouble walking, poor balance, falling, forgetfulness, confusion, mood changes, depression and bladder issues, according to Johns Hopkins. They often develop slowly over a period of three to six months. Initially, normal pressure hydrocephalus can appear similar to Alzheimer's and Parkinson diseases, although health care providers can tell the difference after testing.
How is it treated?
The condition often is treated with a tube called a shunt, which drains the fluid from the brain. The shunt includes two tubes that are inserted into a ventricle, one to let fluid in and the other to let fluid drain. Excess fluid is routed under the skin from the head, through the neck and into the abdomen, where it gets absorbed into the body. The shunt remains in place as long as the excess fluid remains in the brain. The ventricles sometimes go back to their normal size.
Normal pressure hydrocephalus is not typically treated with medicine, because it doesn't respond to it, but medications are sometimes prescribed to treat symptoms.
Because it is a chronic illness, it can't be cured and will get worse without treatment. It's not deadly, but it can cause serious issues such as falls if left untreated.
