Loss of balance could be a very disabling problem. This is especially true in the elderly where a fall cold be life threatening. However, often it is assumed that difficulty with balance is part of aging and patients don’t seek medical attention. Loss of balance could result from multiple causes some of which are treatable and some patients could have dramatic improvement.
A very common cause of imbalance is caused by the disease of the nerves, which causes two problems. If the nerves responsible for sensation stop working, then the limbs become numb and the brain can no longer feel where the legs are causing loss of balance. In these cases, whenever the person is in the dark or closes their eyes, the difficulty with balance worsens. Another problem with nerve disease is that there is loss of strength, generally starting in the feet. In such cases patients develop a foot drop and when they walk their feet do not lift up causing them to trip over them.
An under diagnosed cause of imbalance is muscle disease. Muscle disease generally causes weakness in the thighs and shoulders first. In such cases patients knees give out suddenly and patients describe having sudden falls. There is a sensation that there is a sudden hit to the back of the knees. Such patients also describe difficulty standing up from a chair or going up the stairs. Muscle and nerve disease cold occur at any age. Based on the patients symptoms and physical examination the physician can decide if the patient could have muscle or nerve disease at which point the muscle and nerve are tested by a test called and EMG nerve conduction study. Another class of diseases affects the spinal cord. Any disruption will cause a loss of balance. It could cause loss of sensation in which the patient doesn’t sense their legs, or cause weakness. In addition the patient’s legs could become stiff.
There are multiple causes of spinal cord lesions including multiple sclerosis (MS), spinal cord tumors, cord compression from disk disease, or spinal cord strokes. Once the physician suspects that there might be a cord problem the most common test done is the MRI of the spine and based on those results other tests are performed including lab tests to determine the cause of the problem and possible treatments. This is very important as some conditions could be life threatening and others could cause paralysis and if caught in time some could be completely curable. The last categories of diseases are those that affect the brain. Parkinson’s disease,Multiple Sclerosis are two common diseases that can affect the brain resulting in loss of balance. A neurologist could diagnose Parkinson’s Disease just based on the symptoms and the physical exam. Multiple sclerosis is a disease in which the body attacks the brain and the patients could develop a parkinsonian gait.
Gait imbalance is a very common condition especially in the elderly. Unfortunately it is a very under diagnosed and under treated condition which could severely impact a patient’s life and even be life threatening especially in the elderly. There are multiple conditions that could cause gait imbalance, and it should not be considered a natural part of aging. In order to make the proper diagnosis, at our office, we spend a significant amount of time with you asking thorough questions to fully understand your problem and perform a comprehensive neurological exam during your visit.
Based on our clinical findings, we use the latest technology to make the proper diagnosis. Once the diagnosis is made, we provide you with the latest and most advanced treatments available today. The results could be very rewarding not only for the patient but for the physician as well as some patients could see significant improvement.