Good balance needs many different parts of your body to work together effectively. It may be helpful to think of these different parts of balance being grouped into
input
processing
output
MS can affect all three parts of the balance system. Information your brain receives and the replies it sends out can be late, incomplete or misleading. The messages being passed inside your brain can also be disrupted, which affects the way it processes balance information.
Input
Vision – visual problems, such as blurring or double vision, can give confusing information to the brain when it tries to work out where the body is moving relative to the world around it.
The inner ear – the inner ear constantly updates your brain about the angle and position of the head. If MS has affected the message pathways between your inner ear and the brain, the information may be disrupted or missing, which can add to balance problems.
Sensory changes – changes in sensation, such as numbness or tingling, might mean the brain may not be receiving the accurate information it needs to balance your body properly.
Processing
The way that your brain processes balance information is complex, so the effects that MS can have on this processing are also complex. MS nerve damage in the cerebellum or brainstem can also cause problems with vertigo, sometimes accompanied with nausea.
Output
MS can cause a wide range of symptoms that can have an effect on balance, including difficulties with coordination, tremor and muscle weakness, stiffness or spasms. These symptoms may mean that your muscles aren’t able to respond properly to the instructions being sent to them by your brain; a weak or stiff muscle might not move to the desired position, or may get there too slowly. If this combines with misleading information about where the muscle is, you may find it harder to balance yourself.
Other causes of balance problems
Other MS symptoms
Some symptoms of MS can have an impact on balance, for example, fatigue or muscle spasms or stiffness. Finding ways of managing those symptoms may in turn help you to manage problems with balance.
Relapses
If your balance problems are caused by a relapse, or they get worse during a relapse, then treating the relapse. may improve the problem. Treatment with high dose steroids can usually help to speed up recovery from a relapse.
Rise in body temperature
Your balance might also be affected if your body temperature rises. This is sometimes known as a ‘pseudo relapse’, because it mimics the symptoms of a relapse. These pseudo relapses can be treated by treating whatever’s causing your raised temperature, such as an infection