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Suggest treatment for balance issues, gait and slurred speech

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Posted on Wed, 18 May 2016
Question: I had a mri in oct 14 cerebellum volume loss said it was caused by alcohol stopped drinking shortly after, Dec 14. I was a daily beer drinker since 18 I was 54 then I am 56 now. Main issues BALANCE, GAIT and SLURRED SPEECH. Went to Baylor movement disorder thought it was some kind on Parkinson, prescribed sinemet took 3 times a day at 100mg each 300 total did not help, made me more dizzy. did a c spine mri, did an EMG, some nerves are pinched at L5
doctor
Answered by Dr. Erion Spaho (33 minutes later)
Brief Answer:
Alcoholic encephalopathy.

Detailed Answer:
Hello and thanks for using HCM.

I have read your query and understand your concerns.

Since there is slurred speech, besides gait and balance issues, damage of the cerebellum ( little brain ) by the prolonged alcohol consumption is the most probable and most important cause of your symptoms.

I don't think your condition can be improved by anti Parkinson's drugs use.

Spinal condition such stenosis ( or compression ) of the spinal cord could contribute in gait and balance problems, but, if there were discovered only pinched nerves by clinical evaluation and imaging studies, only pain and sensory changes could be related to it.

In my opinion, your symptoms could be improved by definite stop of alcohol use, healthy diet and vitamin B1, B12 use as a supplement.

Pinched nerves should be treated by physical therapy initially, and NSAID drugs if there are symptoms such pain related to.

Hope you found the answer helpful.

Let me know if I can assist you further.

Greetings.
Above answer was peer-reviewed by : Dr. Naveen Kumar
doctor
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Follow up: Dr. Erion Spaho (22 minutes later)
I was incorrect. Some stenosis c5 c6. It has stayed the same last year. Hair and balance from the get go speech slurred when tired. Now all the time. Last 8mos. Baylor said lot of blood work. Could not put a name to it
doctor
Answered by Dr. Erion Spaho (14 minutes later)
Brief Answer:
Cervical stenosis should be taken in consideration.

Detailed Answer:
Welcome back and thanks for the clarifications.

In this case, then cervical cord stenosis at C5-C6 could contribute to gait and balance problems, besides cerebellum damage, so, it could be in consideration and treated.

An evaluation by a spine specialist or a Neurosurgeon is needed to evaluate the correct treatment possibilities.

Blood work about thyroid gland, liver and kidneys functions should be done.

Vitamin B1, and B12 blood levels should be done as well, in order to achieve a correct understanding of your condition.

Hope I've been of help.

Regards.
Above answer was peer-reviewed by : Dr. Naveen Kumar
doctor
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Follow up: Dr. Erion Spaho (1 hour later)
Thanks
I will follow up with blood and neurosurgeon. I just read the MRI of C Spine and its C6 and C7, narrowing of the canal 6.5-7mm AP and flattening of the cord. Does that make any difference?
doctor
Answered by Dr. Erion Spaho (1 hour later)
Brief Answer:
No difference.

Detailed Answer:
Hello again.

It doesn't make any event, it is actually spinal cord stenosis.

Also, you can start talking vitamin B1, B12 too.

Greetings.
Above answer was peer-reviewed by : Dr. Raju A.T
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Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 4327 Questions

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Suggest treatment for balance issues, gait and slurred speech

Brief Answer: Alcoholic encephalopathy. Detailed Answer: Hello and thanks for using HCM. I have read your query and understand your concerns. Since there is slurred speech, besides gait and balance issues, damage of the cerebellum ( little brain ) by the prolonged alcohol consumption is the most probable and most important cause of your symptoms. I don't think your condition can be improved by anti Parkinson's drugs use. Spinal condition such stenosis ( or compression ) of the spinal cord could contribute in gait and balance problems, but, if there were discovered only pinched nerves by clinical evaluation and imaging studies, only pain and sensory changes could be related to it. In my opinion, your symptoms could be improved by definite stop of alcohol use, healthy diet and vitamin B1, B12 use as a supplement. Pinched nerves should be treated by physical therapy initially, and NSAID drugs if there are symptoms such pain related to. Hope you found the answer helpful. Let me know if I can assist you further. Greetings.