Total loss of ba;ance

[PapaJohnny]

About nine months ago, I started experiencing a loss of balance which quickly resulted in the total loss.  I have had three MRI's and been seen by  a local neurologist and then referred to expert neurologists at Rochester Neuromuscular Center.  I have been diagnosed with ALS but three great doctors at Rochester agree that the loss of balance is not a part of ALS and must be caused by something else.  No one seems to have a clue for my loss of balance.  I am not dizzy and have no symptoms of inner ear problems or anything else that might be the cause.  I have had blood tests for just about everything including Lyme disease but all results are normal.  I have had several falls in the last three months so am now using a walker only for balance to avoid any injuries.  At age 70, I was in prime health and one of the best that my primary doctor had ever seen at that age.  I am now 74.  I can deal with the ALS which seems to be progressing slowly but a return of my balance would greatly improve my quality of life.  Any ideas?
John

[PapaJohnny]

Thanks for your response.  The doctors at Rochester NY Neuromuscular Center stated that it could not be MS because of my age and because several symptoms for MS are not present.  The MRI's of my brain, neck and spinal column along with a spinal tap only show normal wear and nothing significant.

[Dr Sharma]

Hi there. You need to be investigated for multiple sclerosis. MS is a chronic demyelinating disorder where the disease phase is characterized by active phase and remissions. It has multiple symptoms and signs and is a diagnosis of exclusion. The symptoms of multiple sclerosis are loss of balance, muscle spasms, numbness in any area, problems with walking and coordination, tremors in one or more arms and legs. Bowel and bladder symptoms include frequency of micturition, urine leakage, eye symptoms like double vision uncontrollable rapid eye movements, facial pain, painful muscle spasms, tingling, burning in arms or legs, depression, dizziness, hearing loss, fatigue etc. The treatment is essentially limited to symptomatic therapy so the course of action would not change much whether MS has been diagnosed or not. Apart from clinical neurological examination, MRI shows MS as paler areas of demyelination, two different episodes of demyelination separated by one month in at least two different brain locations. Spinal tap is done and CSF electrophoresis reveals oligoclonal bands suggestive of immune activity, which is suggestive but not diagnostic of MS. Demyelinating neurons, transmit nerve signals slower than non-demyelinated ones and can be detected with EP tests. These are visual evoked potentials, brain stem auditory evoked response, and somatosensory evoked potential. Slower nerve responses in any one of these is not confirmatory of MS but can be used to complement diagnosis along with a neurological examination, medical history and an MRI in addition, a spinal tap. Therefore, it would be prudent to consult your neurologist with these concerns. Hope this helps. Take care.