Balance Issues: When to Consult a Neurologist - Neurology

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Hello doctor, I would like to ask two questions.
Occasionally, I feel a slight swaying sensation (usually after using my phone), but it goes away after a while, and I do not experience dizziness or nausea.
What could be the possible causes of this? Additionally, I found a balance test online where I can touch my nose with my eyes closed without any issues, but when I try to stand on one leg with my eyes closed, I can only maintain balance for about 10 to 38 seconds at most before feeling unsteady.
However, I do not experience this when my eyes are open.
Another test involves marching in place with my arms raised, and I noticed that I tend to sway and feel like I'm rotating 15 to 30 degrees.
Should I consider seeing a neurologist for this? Is this also a test for cerebellar function? Could this be related to my late nights? I hope you can provide your insights.
Thank you.

Mo, 20~29 year old female. Ask Date: 2024/03/10

Dr. Jiang Junyi reply Neurology


Hello Mr.
Mo: You mentioned, "Are we testing for cerebellar issues? Is it related to my staying up late?" Staying up late can lead to neuroinflammation, which may result in various symptoms.
The symptoms resemble proprioceptive dysfunction, which refers to the sensory information derived from the contraction and extension of muscles, flexion, extension, pushing, pulling, and the compression of joints between two bones.
Proprioception integrates and utilizes sensory input from deeper tissues such as muscles, joints, and bones, helping individuals perceive various signals from their bodies and informing the brain about the current posture and physiological state.
Blood tests may include the differentiation of possible complications (anemia, hyperthyroidism/hypothyroidism, diabetes, autoimmune diseases, neurosyphilis, and central nervous system disorders).
If symptoms progress, I recommend consulting a neurologist to discuss further examination and treatment.
Thank you for your inquiry, and feel free to discuss further.
Wishing you good health, peace, and happiness.
Dr.
Jiang, concerned about you.

Reply Date: 2024/03/10

More Info


Hello! Thank you for reaching out with your questions regarding balance issues. It’s great that you’re being proactive about your health. Let’s break down your concerns and explore the possible implications.

Firstly, experiencing a sensation of lightheadedness or a slight swaying feeling, especially after using your phone, can be attributed to several factors. One common cause is visual dependency, where your balance system relies heavily on visual input. When you’re focused on your phone, your brain may not be processing other sensory information as effectively, leading to a temporary imbalance. This is often benign and can happen to anyone, especially if they are in a static position for a while.

However, if you notice this sensation occurring frequently or if it escalates in severity, it could indicate an underlying issue that may require further evaluation. Conditions such as vestibular disorders, which affect the inner ear and balance, or even neurological conditions can manifest with similar symptoms.
Regarding your ability to balance while standing on one leg with your eyes closed, this is a classic test for proprioception and balance. The fact that you can stand for only a limited time suggests that your body may be relying heavily on visual cues for balance. When your eyes are closed, your brain has to depend on other systems, such as the vestibular system and proprioception, which may not be functioning optimally.
The test where you noticed a rotation of 15-30 degrees while walking in place with your arms outstretched is also significant. This could indicate a problem with your cerebellum, which is responsible for coordination and balance. If your body is swaying or rotating more than expected, it could suggest that your balance system is not compensating effectively.

As for the relationship between these symptoms and sleep, lack of sleep can certainly affect cognitive function and balance. Sleep deprivation can lead to decreased attention, slower reaction times, and impaired motor skills, all of which can contribute to balance issues. If you are experiencing chronic sleep deprivation, it may be worthwhile to address this as part of your overall health strategy.

Given your symptoms and the tests you’ve performed, it would be prudent to consult a neurologist. They can conduct a thorough evaluation, which may include a neurological examination, balance tests, and possibly imaging studies if deemed necessary. This will help rule out any serious conditions and provide you with a clearer understanding of your balance issues.

In summary, while occasional balance disturbances can be benign, persistent or worsening symptoms warrant a professional evaluation. A neurologist can help determine if there are any underlying issues that need to be addressed and guide you on the appropriate next steps. In the meantime, ensure you are getting adequate rest and consider practicing balance exercises under supervision to improve your stability.

Take care, and I hope you find the answers you’re looking for!

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