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What Causes Sudden Onset Of Severe Gait Problem And Balancing Issues?
Question: My father, aged 79, wt 48 kg is suffering from a sudden onset of severe gait problem, walking and balance problem for two months. He has a history of vestibular disorder and hearing problem but was doing very well with vestibular exercises till last two months. Ent and neurophysicians could not diagonise the problem .For one month he is taking thyronorm 50mg a nd now 100 mg since he has been detected with high TSH of 90, not Hashimoto. His symptoms have not improved much which include severe Insomnia and fatigue, swollen legs and gait disorder with no tremors. Could you kindly suggest the reasons for the persisting symptoms.
Brief Answer:
Hypothyroidism can cause ataxia/MRI Brain should be done.
Detailed Answer:
Hi XXXX,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.
In consideration of the background history of poorly controlled hypothyroidism, the balance problems/gait problems could be a manifestation of ataxia resulting from hypothyroidism.Hypothyroidism is an established cause of ataxia/gait disbalance.Swollen legs and fatigue are also commonly seen in hypothyroidism.
At this point,I suggest that your father should undergo a MRI of brain,to look for cerebellum changes.
Of course,dedicated neurological physical examination will also add a value to the diagnosis.
My opinion is in consideration with the fact that ENT specialist has ruled out any aggravation of vestibular problems because vestibular dysfunction obviously causes gait problems.
Hope that helps.If you have any further questions,I shall be glad to have you in follow-up.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Hypothyroidism can cause ataxia/MRI Brain should be done.
Detailed Answer:
Hi XXXX,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.
In consideration of the background history of poorly controlled hypothyroidism, the balance problems/gait problems could be a manifestation of ataxia resulting from hypothyroidism.Hypothyroidism is an established cause of ataxia/gait disbalance.Swollen legs and fatigue are also commonly seen in hypothyroidism.
At this point,I suggest that your father should undergo a MRI of brain,to look for cerebellum changes.
Of course,dedicated neurological physical examination will also add a value to the diagnosis.
My opinion is in consideration with the fact that ENT specialist has ruled out any aggravation of vestibular problems because vestibular dysfunction obviously causes gait problems.
Hope that helps.If you have any further questions,I shall be glad to have you in follow-up.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you Dr. Panwar for your observation
MRI scan has been done
Impression:
*Few nonspecific gliotic foci in white matter (age related)
*No recent onset infarct seen
MRI scan has been studied by neurologist of Institute of Neurosciensce, no confirmatory diagonisis could me made, Syndopa tried but stopped due to severe onset of tremors which initially not present.
Thyronorm has been started since three weeks. No perceptible improvement observed. How long does it take for the medicine to show its efficacy? Worried since no lead except hypothyroidism has being found yet.
MRI scan has been done
Impression:
*Few nonspecific gliotic foci in white matter (age related)
*No recent onset infarct seen
MRI scan has been studied by neurologist of Institute of Neurosciensce, no confirmatory diagonisis could me made, Syndopa tried but stopped due to severe onset of tremors which initially not present.
Thyronorm has been started since three weeks. No perceptible improvement observed. How long does it take for the medicine to show its efficacy? Worried since no lead except hypothyroidism has being found yet.
Brief Answer:
Needs observation for another 2-3 weeks.
Detailed Answer:
Hi XXXX,
Thanks for being in follow-up.
I have a taken a note of your MRI findings,which are essentially normal.
In the present situation,he needs to be observed for another 2-3 weeks,while being on Thyronorm. Hopefully,he'll show improvement.
Further,what about thyroid autoantibodies? Was he tested for anti-TPO and anti-TG?
Please follow-up with details.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Needs observation for another 2-3 weeks.
Detailed Answer:
Hi XXXX,
Thanks for being in follow-up.
I have a taken a note of your MRI findings,which are essentially normal.
In the present situation,he needs to be observed for another 2-3 weeks,while being on Thyronorm. Hopefully,he'll show improvement.
Further,what about thyroid autoantibodies? Was he tested for anti-TPO and anti-TG?
Please follow-up with details.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Yes Dr. Panwar,
Anti TPO 34.0 IU/ml
Anti TG Antibody 85.0 IU/ml
ANA HEp-2 Negative
Still suffering from severe constipation, insomnia, severe gait disorder
Anti TPO 34.0 IU/ml
Anti TG Antibody 85.0 IU/ml
ANA HEp-2 Negative
Still suffering from severe constipation, insomnia, severe gait disorder
Brief Answer:
Observation.
Detailed Answer:
Hi XXXX,
Thanks for being in follow-up and providing further details.
Anti TPO is in normal range while Anti TG appears to be slightly raised.These values appear to be no significance.
He should continue the same treatment for now and kept under observation.Let's see if he starts improving in another couple of weeks.
If you have some further questions,I shall be glad to have you in follow-up else please close the thread,rate it and write a review.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Observation.
Detailed Answer:
Hi XXXX,
Thanks for being in follow-up and providing further details.
Anti TPO is in normal range while Anti TG appears to be slightly raised.These values appear to be no significance.
He should continue the same treatment for now and kept under observation.Let's see if he starts improving in another couple of weeks.
If you have some further questions,I shall be glad to have you in follow-up else please close the thread,rate it and write a review.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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