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How Should Chronic Balance Issues, Dizziness And Chronic Fungal Sinus Infections Be Treated And Cured?
Question: For 10 years I have had no balance. If I'm not sitting or holding onto something stationary, I will fall, usually backwards. I have been to 7 neurologists, 3 ophthalmologists, 2 internists, a psychologist and a psychiatrist. I have done countless hours of therapy. Now my ENT says I have chronic fungal sinus infections and prescribed Budesonide, Levofloxacin, and Amphotericin to be used in a nebulizer. These have doubled my dizziness and my restless leg problems. He's out of town for 2 weeks and I don't know whether to keep using the nebulizer or stop. Now I also have waves of depression which I've never had before. The only specialty doctor I haven't seen about my dizziness is a rheumatologist.
Brief Answer:
Diagnosis: Psychomotor disadaptation syndrome
Detailed Answer:
Hello,
Since you have undergone elaborate evaluation by different specialists, I believe that obvious causes like Parkinson's, stroke, vitamin B12 deficiency, peripheral neurological, ear and eye problems have already been ruled out.
Now more rare conditions that cause balance issues and falls need to be considered.
Psychomotor disadaptation syndrome is a condition that is seen in elderly individuals resulting in frequent dizziness and falling backward. Psychomotor disadaptation syndrome is caused by age-related changes in subcortical brain and muscles.
Motor Mini test and Backward disequilibrium score, which are clinical tests that can be performed by your primary provider or physiotherapists can confirm the diagnosis.
Management is through physical therapy to improve posture, muscle tone, gait and prevent falls.
Patients with Psychomotor disadaptation syndrome may also experience depression due to frequent fear of falling. The depression can be treated with SSRIs like sertraline.
The worsening of symptoms you noticed recently is likely due to the stress associated with the infection and medications. However, please be advised not to discontinue these medications as fungal infection if left untreated can have major consequences. You can take adequate rest and stay well hydrated while you are on the medications.
Please be advised to follow up with your primary provider to discuss the possibility of Psychomotor disadaptation syndrome.
Hope this answers your question. Please let me know if you need further clarification.
Regards,
Dr. Lekshmi
Diagnosis: Psychomotor disadaptation syndrome
Detailed Answer:
Hello,
Since you have undergone elaborate evaluation by different specialists, I believe that obvious causes like Parkinson's, stroke, vitamin B12 deficiency, peripheral neurological, ear and eye problems have already been ruled out.
Now more rare conditions that cause balance issues and falls need to be considered.
Psychomotor disadaptation syndrome is a condition that is seen in elderly individuals resulting in frequent dizziness and falling backward. Psychomotor disadaptation syndrome is caused by age-related changes in subcortical brain and muscles.
Motor Mini test and Backward disequilibrium score, which are clinical tests that can be performed by your primary provider or physiotherapists can confirm the diagnosis.
Management is through physical therapy to improve posture, muscle tone, gait and prevent falls.
Patients with Psychomotor disadaptation syndrome may also experience depression due to frequent fear of falling. The depression can be treated with SSRIs like sertraline.
The worsening of symptoms you noticed recently is likely due to the stress associated with the infection and medications. However, please be advised not to discontinue these medications as fungal infection if left untreated can have major consequences. You can take adequate rest and stay well hydrated while you are on the medications.
Please be advised to follow up with your primary provider to discuss the possibility of Psychomotor disadaptation syndrome.
Hope this answers your question. Please let me know if you need further clarification.
Regards,
Dr. Lekshmi
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Above answer was peer-reviewed by :
Dr. Prasad
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