Socially and physically loss of balance is a difficult issue to manage. Unfortunately, there is no easy solution, as the loss of balance is basically a problem caused by damage to part of the brain – the
‘cerebellum’ (or its pathways in the brain stem). Other factors can compound the problem, such as spasticity or weakness in the legs. After a while you will probably adjust to some of your problems and, although you may wish to keep going for as long as possible, the most obvious way of helping yourself is by using walking aids (perhaps a stick or crutches); at least these will help you avoid some painful falls and also signal to others that you are not drunk, but that you have some physical problems with movement.

Dizziness

Dizziness (if due to true ‘vertigo’) is when you feel that things around you are moving, or feel that you are moving, sometimes quite rapidly, when in reality neither is happening. This can sometimes be alarming, especially if you feel that you are falling. Sometimes other sensations, like feeling sick (‘nausea’), are associated with vertigo. Dizziness from loss of balance is also related to damage to the cerebellum (or brain stem), the nerve connections to it from the middle ear, or within what is called the ‘vestibular system of the inner ear’. In almost all cases in MS, the dizziness goes away of its own accord after a few hours or days.
Dizziness can be helped by some drugs:

• Steroids (particularly intravenous methylprednisolone) can help when the dizziness is both acute and persistent.
• Diazepam (Valium) is given to dampen down the reflexes of the vestibular system.
• Antihistamines can provide some help if the symptoms of vertigo or dizziness are mild.
• Stemetil (prochlorperazine) may be prescribed.

There is one other apparently strange method that people use: when the vertigo feels worse on moving, exaggerating those movements can sometimes help. Deliberately falling on to a bed (or other very soft surface) on your left and right side, and backwards, three times each way, may ‘rebalance’ the vestibular system, at least temporarily. You may also find that there is a particular position that lessens the vertigo, such as lying on one side rather than another. There is also some evidence that tolerance can develop (e.g. dizziness can be lessened) if you can, with professional help, maintain the position of your head, when the dizziness is at its worst, for as long as possible. Of course, this approach can be rather uncomfortable until tolerance increases.