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Feeling unsteady. Having momentary loss of balance. Having tight feeling in head. What could be the problem?

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Feel unsteady as I walk with a momentary loss of balance, not always but quite a few times. Dull tight feeling in the head

Sometimes when I turn my head I feel reeling sensation and momentary loss of balance
Posted Mon, 15 Jul 2013 in Headache and Migraines
Answered by Dr. Sandhya Manorenj 22 hours later

Thank you for writing to me.

From your query I learn that you have prior history of bronchial asthma, have unsteadiness while walking with loss of balance totally at times , with tightness in head with reeling sensation

From neurological perspective, the most common causes of unsteadiness while walking at your age includes Posterior circulation stroke (cerebellar stroke ,where cerebellum is responsible for the balance), multiple small vessel disease of brain, parkinsonism and normal pressure hydrocephalus. Remote possibility is cervical and lumbosacral spondylosis and peripheral neuropathy.

To arrive at a diagnosis a detailed history would be necessary.
May I know if the symptoms were sudden in onset or if they have been present for a long period of time? Is there any weakness of one side? Do you have vomiting with vertigo (rotational feeling)? Is there mild shaking of hands? Are you able to perform daily activities without difficulties? Do you walk with with short steps/have constant fear of falling while walking? How is the your memory?

MRI scan is an useful investigation tool to rule out the aforementioned possibilities. Other investigation procedures that are helpful are lipid profile and sugar tests.

Ear condition such as benign positional vertigo is another close possibility. Cervical spondylosis with canal stenosis also present with vertigo on turning head. You may also have neck pain and headache and root pain involving hands if cervical spondylosis is the cause.

In view of multiple possibilities, to help us identify the exact cause, I suggest you to consult Neurophysician there at Bangalore and get evaluated in detail. You may require MRI brain with screening of cervical spine , with blood sugar ,blood pressure and cholesterol checked.

Everything is treatable one. You need not worry. Hope this would help you.

Above answer was peer-reviewed by
Follow-up: Feeling unsteady. Having momentary loss of balance. Having tight feeling in head. What could be the problem? 17 hours later
Yes this feeling is for the past several years possibly 6 to 7 years or more Two years ago I had a MRI scan of the brain done, the result being normal also blood test for Vitamin B12 deficiency done and found at the lower side of band. Cap " Nervagin" prescribed by doc.
also had some sporadic treatment for Virtigo
Answered by Dr. Sandhya Manorenj 7 hours later

Since MRI brain is normal and duration of symptom is long (6-7 yrs), these rules out acute stroke - small vessel disease of brain and normal pressure hydrocephalus.

Lower range of vitamin B12 can lead to peripheral neuropathy and unsteadiness while walking due to loss of sensory control, it also affects the vestibulocochlear nerve (ear nerve ) and lead to vertigo.

You may require limbs (for confirming neuropathy), pure tone audiometry (for ear nerve), ENT examination and cervical spine screening (as Vitamin B12 deficiency can also affect cervical spinal cord) to make sure the exact cause of unsteadiness and vertigo

Meantime you can have
1) Vitamin b12 XXXXXXX diet (non vegetarian diet),
2) Nervigen to continue
3) Brandt Darroffs vestibular rehabilitation exercise to strenghthen vestibular apparatus
4) Betahistine short course when ever you have vertigo.

Please get back if you require any additional clarification.


Above answer was peer-reviewed by
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