Brief Answer:
Need to exclude peripheral neuropathy also.

Detailed Answer:
Hi,

Thank you for posting your query.

I am Dr Sudhir Kumar, Neurologist, and would try my best to help you.

Based on symptoms, we need to exclude peripheral neuropathy. In this condition, the sensory nerves located in the skin over feet/legs get affected. So, one is not able to perceive the sensations of ground, resulting in imbalance and positive Rhomberg's sign. NCS (nerve conduction studies) can confirm or exclude a diagnosis of peripheral neuropathy.

Vitamin B12 deficiency, diabetes mellitus and thyroid disease are common causes of peripheral neuropathy. They can be ruled out by appropriate blood tests.

Labyrinthine (vestibular) dysfunction due to MVA or an unrelated cause can also cause imbalance. An ENT examination could help in excluding this condition.

I sincerely hope my reply has helped you.
     
I would be pleased to answer, if you have any follow up queries or if you require any further information.
     
Best wishes,     
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX
For DIRECT QUERY to me: http://bit.ly/Dr-Sudhir-kumar
My blog: http://bestneurodoctor.blogspot.com/

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Brief Answer:
Vestibular dysfunction is the most likely cause

Detailed Answer:
Thank you for getting back with additional information.

Based on that, brain-related diseases and peripheral neuropathy have been excluded.

Vestibular dysfunction related to MVA seems to be the most likely cause. Opinion from a Neuro-otologist would be valuable, as they can do specific tests to assess the vestibular dysfunction, which can then be followed by medications and vestibular adaptation exercises.

Dr Sudhir Kumar MD DM

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