From the Research
Yes, balance issues can be the first symptom or event in multiple sclerosis (MS). MS is an autoimmune disease that affects the central nervous system, causing damage to the myelin sheath that protects nerve fibers. When MS affects areas of the brain responsible for coordination and balance, such as the cerebellum or brainstem, balance problems can emerge as an initial symptom. These balance difficulties may present as unsteadiness, dizziness, vertigo, or a feeling of lightheadedness. Patients might experience difficulty walking in a straight line, maintaining posture, or may feel like they're being pulled to one side. The reason balance problems occur is because MS lesions disrupt the normal transmission of nerve signals that coordinate movement and spatial awareness.
According to a study published in 2018 1, balance dysfunction in MS is conceptualized as three interrelated problems: decreased ability to maintain position, limited and slowed movement towards limits of stability, and delayed responses to postural displacements and perturbations. Another study published in 2008 2 found that balance problems and falls are common in people with MS, and that the cause and nature of these problems are not well understood. However, the most recent study published in 2021 3 found that visual cue guided multidirectional step training can improve balance, gait, and mobility in individuals with MS.
Some key points to consider when evaluating balance issues in MS include:
- The importance of early diagnosis and treatment to manage symptoms and potentially slow disease progression
- The role of physical therapy, medications, and assistive devices in addressing balance problems and other MS symptoms
- The need for ongoing monitoring and adjustment of treatment plans to optimize outcomes and improve quality of life
In terms of treatment options, physical therapy specifically focused on balance training is a recommended approach. This can help improve balance, gait, and mobility, and reduce the risk of falls and other complications. Medications to address MS disease activity, such as interferons-beta and glatiramer acetate, may also be prescribed, although the choice of medication should be individualized based on the patient's specific needs and circumstances, as noted in a study published in 2016 4. Overall, a comprehensive and multidisciplinary approach to managing MS symptoms, including balance problems, is essential for optimizing outcomes and improving quality of life.