Untreated MS and falling sensation

[EmmieOd1]

I am 64 on Medicare and can no longer afford Copaxone. I haven't used copaxone for 2 years now. I have sudden feelings of falling when I am on the edge of anything, a curb, stairs, even when driving over an overpass. This is really causing extreme anxiety and keeps me from being active. I have tried exercising but it made it worse. My primary care physician told me this was neurological but on a fixed income, I can't afford a specialist or the medication. Does anyone know of a possible vitamin deficiency that could be causing this? Any possible supplements that could help. I have to rely on alternative sources due to finances

[supermum_ms]

You may feel like your going a tad nuts but your probably not :) i actually know a few people who've experienced a type of visual induced vertigo.....its also most 2am over my side of the world down under so i'll have to get my hands on some information, tips and tricks tomorrow and get back to you.......JJ

[EmmieOd1]

Thanks any information would be greatly appreciated. Goodnight,  sleep well.

[supermum_ms]

Okay i've finally found some information but remember you need to know exactly what is causing this otherwise you can inadvertently make things worse...

"The visuo-vestibular interaction is of particular clinical relevance to patients suffering from visually-induced dizziness 36-38 previously known as visual vertigo, ‘visuo-vestibular mismatch’39 or ‘space and motion discomfort’.40 Patients with visually-induced dizziness report dizziness, unsteadiness and disorientation in visually disorienting surroundings but typically not classical rotational vertigo. The distinguishing characteristic of these patients compared to other dizziness patients is their tendency to be over reliant upon vision for postural control and balance, a situation termed ‘visual dependency’.37 Visually-induced dizziness appears to be the end result of repeated exposure to dizziness developing in diagnoses as disparate as vestibular migraine (see consensus statement on diagnosis of vestibular migraine41) BPPV or post-vestibular neuritis........An understanding of the brain mechanisms mediating visual and vestibular interaction has been little studied however multi-modal research involving neuroimaging, lesion mapping and more recently with TMS has enabled a mechanistic explanation for patients’ symptoms and the logical development of their treatment. There are many unanswered pertaining to the modulators of visual-vestibular interaction, such as migraine, anxiety and co-existing medical and neurological disorders."  http://www.acnr.co.uk/2013/09/visual-vestibular-interaction-basic-science-to-clinical-relevance/

"We now investigate another factor which may perpetuate symptoms in patients with balance disorders (Bronstein, 1995), namely the presence of increased visual dependence (Witkin and Asch, 1948; Witkin, 1959). The question was prompted by the observation that patients often report onset or worsening of symptoms in visual surroundings with increased visual motion (Hood, 1980; Page and Gresty, 1985; Jacob et al., 1989; Bronstein, 1995; Baloh, 1996). Whilst visually or driving-induced symptoms may be due to anxiety or panic disorders, there is evidence that a vestibular disorder can be the underlying cause (Page and Gresty, 1985; Jacob et al., 1989, 1996; Bronstein, 1995).

In a previous study, some patients with VV due to underlying peripheral or central vestibular disorders showed abnormally large postural responses to optokinetic stimulation (Bronstein, 1995). It was postulated that the combination of a vestibular disorder and enhanced visual dependence could explain why some patients experience visual triggering of their symptoms. The concept of visual dependence derives from the fact that spatial orientation is based on both gravito-inertial (vestibulo-proprioceptive) and visual cues, and that normal human subjects make variable and idiosyncratic use of such cues for spatial orientation (Witkin and Asch, 1948; Witkin, 1959; Guerraz et al., 1998) and postural control (Isableu et al., 1998). Essentially, in the presence of conflict between sensory modalities, visual-dependent subjects rely more on visual cues whereas visual-independent subjects rely more on vestibulo-proprioceptive cues. It is likely that such perceptual preferences observed in normal subjects are also present, if not enhanced, in balance disorder patients. In fact, in postural studies of unselected patients with vestibular lesions, some patients are clearly more susceptible than others to conditions of distorted visual feedback, e.g. a sway-coupled visual surround (Shepard et al., 1993; Shumway-Cook et al., 1996)." https://academic.oup.com/brain/article/124/8/1646/479980

[Note the above articles provide long lists of additional reference research information that you might find helpful in understanding why this is happening and provide you with some direction to follow]

http://www.themsgym.com/

is MS specific free online physio for different issues, i believe they will be able to give you some exercise direction and support.

I'd recommend you contact your local MS society, as a dx pwMS you should be to access free services and depending on your circumstances it's possible you'll be able to get at a home assessment, physio and psych sessions to help you with this. Your NOT alone!!

I hope this helps.....JJ

[supermum_ms]

Hi and welcome,

I think your dr may be attributing what's been happening to you to be neurological, it's likely he/she is meaning your dealing with a faulty proprioception or visual depth perception issue which are both common in pwMS....are you loosing your balance and actually falling sometimes?

Do you keep balance but experience the sensation of falling but you've not actually moved?  Does the curb height seem the same as if your standing on the edge of a cliff, do cracks in the pavement seem wider or deeper than they are, do steps seem higher or lower than they are? Does a dark or low light environment make a difference?

Sorry for all the questions but it can help work out the different things that might help you or not.......JJ  

[EmmieOd1]

I don't fall, I just get the adrenaline rush that you would get just before falling.  I guess I should have described it as the fight or flight feeling when there is no reason for it. Logically I know that I am not falling or even about to.  It has developed into an extreme fear of heights that I just can't get past.  I have tried 'facing my fear' but that didn't work. I think it may be a depth perception thing but visually I see just fine. I go up and down stairs just fine in my home, but in unfamiliar places, I cling to the railing. As far as lighting, if I see it, I  feel it. Even on TV if someone is up high or a car goes over a bridge,  I have to look away or I get that adrenaline rush. Maybe, I'm just nuts.