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Sudden vomiting, disorientation, balance problems, weight loss, no history of vomiting

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General & Family Physician
Practicing since : 2004
Answered : 540 Questions
My father is 76 and in the last week he has had two sudden episodes of vomiting and disorientation. When this hits he also has problem standing on his legs (i.e. we have to go get him up and put him in bed as he is too unsteady to do it himself). He is not a person that was ever prone to vomiting in his lifetime. He has also been losing so weight lately but not too excessive (less than 20 lbs). Please advise
Posted Tue, 24 Apr 2012 in Brain and Spine
Answered by Dr. Sujeet N Charugulla 19 minutes later

Thanks for your query.

I shall address your concern based on your current given information.

Considering the aspects of your father who indeed is elderly are prone to falls physiologically even without any medical problem, I can think of the following conditions:

1. Now that he is a known hypertensive - blood pressure fall due to excessive dose of any prescribed medicine, would cause falls; but rarely associated with vomiting and disorientation as you have said.

2. Next, diabetes on his list, would again pose a similar situation if his serum glucose levels drop majorly due to aggressive therapy or poor diet intake. Here, again disorientation might occur with the fall, but rarely vomiting unless complicated by other important clinical features, out of this context.

3. Numerous back surgeries may not have a direct relation with the present symptoms although, his spinal muscles may itself be a concern if weak.

Weight loss as per your reading should be compared to his total body weight before and the reason for this should be evaluated clinically.

4. Apart from above visible history, conditions of ear especially are known to cause such symptoms, and attempt should be made if any lurking/chronic infection in his inner ear might have caused this. It would be probable but not the only one.

5. Rest, lesser important causes would need review but once these all are considered.

I hope I have answered your concern on a broad sense, now.

If you have additional questions regarding these recommendations, please feel free to post them here, I will be available to address them.

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