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Suggest Treatment For Dizziness, Imbalance And Weakness In Legs
Question: I am a male 43 yrs . I have been experiencing dizziness and balance issues for las couple of weeks. I have been to an ENT specialist who gave me stugeron forte and verbet .8 for dizziness. I also under went an MRI brain for that yesterday. However now the dizziness has resolved mostly i am experiencing weakness in legs . I am unable to walk in a straight line . I feel very scared . The MRI report is normal . I cant walk
Brief Answer:
vestibular rehabilitation exercises, 6-8weeks
Detailed Answer:
Hi,
Thank you for your query.
1. Since your MRI is within normal limits, most of the serious causes for dizziness have been ruled out.
2. It is imporant to check for positional vertigo, check the hearing (which is affected in labyrinthitis), vestibular neuritis and a neurological examination.
3. Vertigo causes loss of confidence and weakness. If your cerebellar signs are negative, it will take 6-8 weeks for the brain to compensate.
4. Vestibular suppression by these medications affects this compensation mechanism, hence these medications are used initially for severe vertigo.
5. Vestibular rehabilitation exercises are helpful. It is better to be careful to avoid falls due to the vertigo. Reevaluate after 6-8 weeks.
If you have any more questions I will be available to answer them.
Regards.
vestibular rehabilitation exercises, 6-8weeks
Detailed Answer:
Hi,
Thank you for your query.
1. Since your MRI is within normal limits, most of the serious causes for dizziness have been ruled out.
2. It is imporant to check for positional vertigo, check the hearing (which is affected in labyrinthitis), vestibular neuritis and a neurological examination.
3. Vertigo causes loss of confidence and weakness. If your cerebellar signs are negative, it will take 6-8 weeks for the brain to compensate.
4. Vestibular suppression by these medications affects this compensation mechanism, hence these medications are used initially for severe vertigo.
5. Vestibular rehabilitation exercises are helpful. It is better to be careful to avoid falls due to the vertigo. Reevaluate after 6-8 weeks.
If you have any more questions I will be available to answer them.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
My GP has put me on meganeuron od capsules . He says the balance issues cud be related to vitamin b12 deficiency . I am a vegitarian with previous record of vit b 12 deficiency
Brief Answer:
Vit B12 causes muscle weakness.
Detailed Answer:
Hi,
Thank you for writing back.
1. Vitamin B12 deficiency is more likely to be a cause of the weakness in the legs (sensory ataxia) than vertigo.
2. This is reversible and easily treated. You may also get the Vitamin B12 levels tested to monitor the results of the therapy.
If you have any more questions I will be available to answer them.
Regards.
Vit B12 causes muscle weakness.
Detailed Answer:
Hi,
Thank you for writing back.
1. Vitamin B12 deficiency is more likely to be a cause of the weakness in the legs (sensory ataxia) than vertigo.
2. This is reversible and easily treated. You may also get the Vitamin B12 levels tested to monitor the results of the therapy.
If you have any more questions I will be available to answer them.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Been to the ENT specialist as i had to show him the MRI report . He asked me to see a neurophysician for my balance issues. The MRI is normal as i have told you yesterday . What is your opinion about seeing a neurologist (being one yourself ) ? Or shall i wait for the vit B 12 course to get over ?
Brief Answer:
You should get a neurologist's opinion.
Detailed Answer:
Hi,
Thank you for writing back.
1. It is always better to get a neurophysician's opinion since you have weakness in the legs and cannot walk in a straight line.
2. It is important for the neurologist to observe any cerebellar signs to rule out central vertigo. Certain signs such as nystagmus (abnormal eye movements) cannot be assessed by the patient. Subtle neurological signs require thorough examination to rule out.
3. The Vitamin B 12 course can continue in the meantime.
If you have any more questions I will be available to answer them.
Regards.
You should get a neurologist's opinion.
Detailed Answer:
Hi,
Thank you for writing back.
1. It is always better to get a neurophysician's opinion since you have weakness in the legs and cannot walk in a straight line.
2. It is important for the neurologist to observe any cerebellar signs to rule out central vertigo. Certain signs such as nystagmus (abnormal eye movements) cannot be assessed by the patient. Subtle neurological signs require thorough examination to rule out.
3. The Vitamin B 12 course can continue in the meantime.
If you have any more questions I will be available to answer them.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I have been to a neurologist today. He conducted a few tests like ENG , balance assessment and thyroid anti body . The results are as following 1) ENG :-This is an abnormal ENG study suggestive of right irritative vestibulopathy . 2) Balance assessment :- moderate balance deficit , no sensory or motor ataxia . The dr has put me on 1) 1/2. Tablet lasilactone in the morning .2) vertin OD once a day 3) stugeron forte twice a day. What is the emaning of these reports ? What is your opinion about the treatment suggested . Also the dr has asked me to see him after i get the blood reports.
Brief Answer:
You will recover soon.
Detailed Answer:
Hi,
Thank you for writing back.
1. These test results suggest a peripheral lesion in the ear. The brain seems normal. This is a good situation where recovery should be good.
2. The neurologist also suspects Meniere's Disease (endolymphatic hydrops) and hence has prescribed a diuretic. I am assuming that your blood pressure is within normal limits. A trial with a salt restricted diet and acetazolamide (Diamox) will be better.
3. The trend now is to give either vertin (betahistine) or stugeron (cinnarizine) and not both together.
If you have any more questions I will be available to answer them.
Regards.
You will recover soon.
Detailed Answer:
Hi,
Thank you for writing back.
1. These test results suggest a peripheral lesion in the ear. The brain seems normal. This is a good situation where recovery should be good.
2. The neurologist also suspects Meniere's Disease (endolymphatic hydrops) and hence has prescribed a diuretic. I am assuming that your blood pressure is within normal limits. A trial with a salt restricted diet and acetazolamide (Diamox) will be better.
3. The trend now is to give either vertin (betahistine) or stugeron (cinnarizine) and not both together.
If you have any more questions I will be available to answer them.
Regards.
Above answer was peer-reviewed by :
Dr. Raju A.T
My blood reports for thyroid panel , thyroid anti bodies have come out normal . Vit b12 normal vit d inssufficienct . I had been to a neuro with my reports . Now he has confirmed his diagnosis for VESTIBULAR NEURITIS . He has added defcort 30 x 2 a day to previous Rx and also has added a vit supplement to be taken once a week . He told me that this neuritis is going to resolve on its own and the steroid is to speed up the recovery . And rest is treatment for symptoms. I must add that i am feeling much better since i asked the first question to you . What do you think about this whole issue . I am still feeeling very scared from that episode . Also if taking defcort 30 is safe ?
Brief Answer:
Vestibular Neuritis is self limiting.
Detailed Answer:
Hi,
Thank you for writing back.
1. Vestibular Neuritis is a self limiting disease. Active medication is not necessary in all patients, however supportive medication such as steroids, anti-vertigo drugs, anti-virals, sedatives and vestibular rehabilitation exercises are given.
2. Vitamin B12 and Vitamin D supplementation will help control the other symptoms. It is good to hear that the thyroid tests are normal.
3. The main issue is ruling out a stroke. Vestibular Neuritis is a clinical diagnosis. Was thereany mention of nystagmus (abnormal eye movements in the clinical examination notes?). Recover usually takes a few weeks. If the dizziness persists, further tests may have to be done.
4. The steroid dose (Defcort/ deflazacort 30mg twice a day) is safe. If a infection is suspected be alert for a flare-up, in which case the steroids should be given under the cover of antibiotics and anti-virals.
5. Vestibular Neuritis is usually a limited episode. It may recur in a few patients and that is unpredictable, as is the exact recovery time.
If you have any more questions I will be available to answer them.
Regards.
Vestibular Neuritis is self limiting.
Detailed Answer:
Hi,
Thank you for writing back.
1. Vestibular Neuritis is a self limiting disease. Active medication is not necessary in all patients, however supportive medication such as steroids, anti-vertigo drugs, anti-virals, sedatives and vestibular rehabilitation exercises are given.
2. Vitamin B12 and Vitamin D supplementation will help control the other symptoms. It is good to hear that the thyroid tests are normal.
3. The main issue is ruling out a stroke. Vestibular Neuritis is a clinical diagnosis. Was thereany mention of nystagmus (abnormal eye movements in the clinical examination notes?). Recover usually takes a few weeks. If the dizziness persists, further tests may have to be done.
4. The steroid dose (Defcort/ deflazacort 30mg twice a day) is safe. If a infection is suspected be alert for a flare-up, in which case the steroids should be given under the cover of antibiotics and anti-virals.
5. Vestibular Neuritis is usually a limited episode. It may recur in a few patients and that is unpredictable, as is the exact recovery time.
If you have any more questions I will be available to answer them.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi ,
Today is my third day with steroid medication . I must say that the intensity of the symptoms has come down markedly . I feel much better . However my legs still feel very weak and the balance problem comes back if i stand for some time . Is this expected . (Yes i understand i am being impatient ) i do feel relaxed once i lie down . Hopr the progress is as expected . A friend of mine is a homeopath and he suggests that once the course of steroids is over i should take homeopathic treatment . What is your take on it ?
Today is my third day with steroid medication . I must say that the intensity of the symptoms has come down markedly . I feel much better . However my legs still feel very weak and the balance problem comes back if i stand for some time . Is this expected . (Yes i understand i am being impatient ) i do feel relaxed once i lie down . Hopr the progress is as expected . A friend of mine is a homeopath and he suggests that once the course of steroids is over i should take homeopathic treatment . What is your take on it ?
Brief Answer:
Recovery takes 6-8 weeks. Homeopathy is fine.
Detailed Answer:
Hi,
Thank you for writing back.
1. It will take a few weeks for recovery. It is common for slight unsteadiness at times to linger on. The medication and physiotherapy will speed up the recovery and lead to early relief from symptoms.
2. There is no harm in taking homeopathic treatment.
If you have any more questions I will be available to answer them.
Regards.
Recovery takes 6-8 weeks. Homeopathy is fine.
Detailed Answer:
Hi,
Thank you for writing back.
1. It will take a few weeks for recovery. It is common for slight unsteadiness at times to linger on. The medication and physiotherapy will speed up the recovery and lead to early relief from symptoms.
2. There is no harm in taking homeopathic treatment.
If you have any more questions I will be available to answer them.
Regards.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
Above answer was peer-reviewed by :
Dr. Raju A.T
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