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I would say for the past year I notice that If I walk slow,

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or walk on unlevel ground...
I would say for the past year I notice that If I walk slow, or walk on unlevel ground, I cannot walk straight. I also lean to the right where I can almost lose my balance. I also, not often, maybe one to three or four months get a painful zinging pain in my right temple. Yesterday I felt pain in the temple and when I touched it I felt a small pea sized hard knot and I could follow it move across the top of my right eye and then down my right side of my nose down to like down to the bottom right side of my nostril. It felt kind of numb and sore at the same time, and within a couple of moments it went away. I am 69 years old and have had high blood pressure since I was in my 20's. I mentioned it to my doctor and he referred me to a neurologist about 6 months ago but I just haven't went as yet, I guess because I don't want to be told I have a brain tumor or something. I already have bullous emphysema since 2002. I smoked from like 12 to 54 years old, then my lung collapsed on its own, and that is how I found out I had emphysema. I just want to know though, what do you think of these symptoms with my gait, and a few times a day I keep leaning to my right side where I have to catch myself and get back in line?
Submitted: 8 months ago.Category: Neurology
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Answered in 9 minutes by:
11/14/2017
Neurologist: drphophalia, Other replied 8 months ago
drphophalia
Category: Neurology
Satisfied Customers: 38,748
Experience: Regularly deal with musculoskeletal neurology, spinal issues, bowel and bladder dysfunctions etc.
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Neurologist: drphophalia, Other replied 8 months ago

Let me at the outset tell you that your symptoms are not due to brain tumor.

The problems can be due;

1) Age related changes in the cerebellum.

2) Visual issues.

3) Spinal issues

4) Orthopedic problem

5) Neuropathy or nerve issues.

Following are the possible causes of balance and incoordination problem;

1) Sitting balance and arising from chair problem; proximal muscle weakness, arthritis, or neurologic disease are the causes. Treatment is muscle-strengthening exercises, and treatment of specific conditions, such as arthritis.

2) Neck turning and extension; Neck arthritis (cervical arthritis, cervical spondylosis), or vertebral-basilar insufficiency can cause this. Treatment options include avoidance of quick head-turning and physical therapy.

3) Standing balance; causes are orthostatic hypotension, cerebellar disease, sensory deficits, muscle weakness, or pain. Treatments are muscle strengthening, using an assistive device, improved foot care, medication adjustment, and treatment of specific diseases.

4) Unstable turning around; causes to consider are cerebellar disease, hemiparesis (stroke), visual field cut, or reduced proprioception (sensation). Treatment possibilities are assistive devices, proper shoes and gait training.

5) Unsafe sitting down; may have proximal muscle weakness or poor vision. Treatment options include muscle strengthening, raising the height of the seat, and visual assessment.

You would need a neurological assessment and following investigations;

a) Muscle charting for the muscle strength

b) MRI of the brain and spine

c) Electromyography

d) Blood work like CK which is a muscle enzyme.

Treatment had been discussed above and is dependent on the diagnosis. Mainstay of the treatment is physical therapy.

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Neurologist: drphophalia, Other replied 8 months ago

Balance can be affected by gradual changes due to aging or side effects of medications. Host of health problems can also lead to unsteadiness.

Following is advised;

1) Walking, biking, and climbing stairs strengthen muscles in your lower body. A recumbent bike or stair stepper may also be good.

2) Stretching loosens tight muscles, which can affect posture and balance.

3) Yoga; strengthens and stretches tight muscles and improve static and dynamic balance skills.

4) Tai chi moves; involve gradual shifts of weight from one foot to another combined with rotating the trunk and extending the limbs, to improve balance.

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Neurologist: drphophalia, Other replied 8 months ago

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