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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 35463
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I occasionally wake feeling off-balance. Very minmal

Customer Question

Hello I occasionally wake feeling off-balance. Very minmal spinning more like the room is tilted so I stumble around. Had a clean brain scan less than a year ago. No issues with my ears. Good blood pressure. I do however suffer anxiety. I wake several times at night. I have horrible vision but have glasses. Prescription is up to date. No diabetes. No heart issues. Severe allergies but take Claritin every morning. So whats left on possible causes?
Submitted: 2 years ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 2 years ago.
I am Dr. Arun and will be helping you today.
I am sorry that your question was unanswered for long.
Following are the common causes in your age group;
1) Acoustic neuroma
2) Vestibular neuronitis
3) Inner diseases; mainly these are autoimmune disorders and may have other issues associated like arthritis.
4) Benign Paroxysmal positional vertigo.
5) Migraine
6) Meniere disease.
7) Neuropathy
8) Orthopedic disorders
9) Thyroid issues
10) Anxiety and depression
11) Cerebellar disorders
12) Postural hypotension
Following are the investigations which will clinch the diagnosis;
1) audiometry,
2) vestibular tests.
The most commonly performed vestibular tests are as follows:
Electronystagmography (ENG)The rotating-chair test, also referred to as sinusoidal harmonic acceleration (SHA), Computerized dynamic posturography (CDP).
3) blood tests for autoimmune disorders,
4) computed tomography (CT), and magnetic resonance imaging (MRI).
5) The saccadic test
6) The gaze test
7) Pursuit eye movements test
8) Optokinetic Nystagmus test
9) Head shake nystagmus test.
10) Positional nystagmus testing
11) Bithermal calorie test.
12) Rotating chair test.
13) An alternative to the rotating-chair test is the active head-rotation test,
14) Computerized dynamic posturography
An ENT specialist and a neurologist with a Rehab specialist in tandem are involved in the investigative work up and care.
An exercise program, may help, till you are investigated.
Exercises are graded in difficulty based on velocity of head and object motion and by progression of body positioning from sitting to standing to walking. The exercises are graded in difficulty by narrowing the base of support, making the surface uneven, or changing the surface from firm to soft. Varied walking exercises are graded in difficulty by changing direction, requiring performance with the eyes closed, increasing speed of ambulation, walking on soft surfaces, or navigating stairs. An aerobic exercise home program progressively increasing the time, speed, or distance that one could tolerate also can be initiated. But all of these may need supervision of a doctor if off balance is severe.
It is privilege assisting you.
Please let me know if you have further queries or unanswered questions.
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Thank you.
Wishing you all the very best in life.
Expert:  Dr. Arun Phophalia replied 2 years ago.
Thank you for the opportunity to answer completely your Question. Please make sure to rate me because that is how I am credited for my work.
Now, I will provide an Additional Service offer so that you have this option available on your question list to get a hold of me directly in the future.
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- if you would like to schedule a new, private email session or to ask me directly a new question. It's up to you.
Thank you.
Expert:  Dr. Arun Phophalia replied 2 years ago.
Hope you are doing good.
Let me know if I can help you further.
Wishing you all the very best in life.