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Lack of balance, wobbly gait, and just falling have been

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Posted on Wed, 27 Feb 2019
Question: Lack of balance, wobbly gait, and just falling have been with me for 5 years now. I have 3 kinds of falls: the usual dizzy fall, the no-warning fall, and worst, the "body-slam" fall which is one that seems like someone slammed you to the ground with resulting injuries.I have had 2 of those. Now I've experienced "catatonic" incidents. I have a short "spacy" feeling and then I am like frozen. I can hear; I know what's going on; I know what people are saying but I can only shake all over and cry. I have no control over either. Gradually everything stops but I am exhausted even though the incident seems to last only 4-10 minutes. I have run out of doctors. I think all they see is an overweight woman with emotional issues. I am scheduled for brain scan Wednesday but no answers on the last one.
                                                       
                                                       
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Answered by Dr. Vaishalee Punj (2 hours later)
Brief Answer:
Can be narcolepsy, cataplexy

Detailed Answer:
Hello and welcome to Ask A Doctor service.

I have reviewed your query and here is my advice.

The dizzy fall and no warning fall seem cataplxy. Body slam seems to be narcoplexy or some type of epilepsy. Cerebellar disorders need to be ruled out.

It is good that a scan is planned. A sleep study and EEG is also helpful, especially when conducted during an episode.

Kindly let me know how this problem started? Are you on any medicines?

Dr Vaishalee
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Vaishalee Punj (8 hours later)
My list of drugs is in the first question which Dr. Gurabardhi says she answered but I can't find the answer. My list of drugs is extensive; if it's not where you see it, I'll send it again.
You are the first to mention these two possibilities and they seem very likely to be the problem. What kind of doctor should I go to?
doctor
Answered by Dr. Vaishalee Punj (13 hours later)
Brief Answer:
Two possibilities are there

Detailed Answer:
Hi again

I have studied your case from previous queries.

Either its some combination of cataplexy/narcoplexy/epilepsy. Or its ataxia/dysarthria from use of medicines/cervical surgery/cerebellum problems. Most likely its combination of both i.e ataxia/medicine exacerbating cataplexy.

Scan will help find any cerebellar problems
EEG will help detect any epilepsy
Sleep study will help detect any cataplexy/naroplexy.

Since previous scans didn't show anything, its probably not related to any cerebellar issues.

A neurologist is best able to deal with the problem. If neurologist is not available, then a family physician can also deal with it. They usually prescribe anti-depressants for cataplexy. They have not found a cure for it.

My suggestion is as follows:
- Drink cleaner water with lowest TDS to prevent any ear, nose, throat infections that may spread to brain
- Do alternate nostril breathing to help clear nasal blocks and also increase air supply to lungs and brain. Deep breathing/breathing exercises should also help.
- Keep the medicines for RLS to the minimum possible as these can exacerabate ataxia
- Take precautions for the falls and injuries. Extra medicine doesnot seem necessary. Can consult neurologist for further consultation about the problem.

Hope this helps. Let me know if you have further doubts about it.
Dr Vaishalee
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Vaishalee Punj

General & Family Physician

Practicing since :2003

Answered : 2383 Questions

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Lack of balance, wobbly gait, and just falling have been

Brief Answer: Can be narcolepsy, cataplexy Detailed Answer: Hello and welcome to Ask A Doctor service. I have reviewed your query and here is my advice. The dizzy fall and no warning fall seem cataplxy. Body slam seems to be narcoplexy or some type of epilepsy. Cerebellar disorders need to be ruled out. It is good that a scan is planned. A sleep study and EEG is also helpful, especially when conducted during an episode. Kindly let me know how this problem started? Are you on any medicines? Dr Vaishalee