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My mom has complained of "balance problems" for the last few years. She attributes it to the lamictal she has to take to prevent seizures, but I'm wondering if this could be related to the dementia? There are days she has a hard time walking and will say "my balance is really bad today".... would a med side effect vary day to day?


Her old neurologist tried her on other seizure meds, nothing improved as far as the balance problem. She did a lot better mood-wise on the lamictal so she ended up back on lamictal.


Just really hoping these balance problems don't progress, so I want to understand what is causing it. If it is the med, then it shouldn't progress, right?

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My mom's balance does vary depending upon her strength and amount of sleep she's gotten the night before. She has a physical therapist who works with her three times weekly and gives her exercises to practice
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Reply to salutem
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Have you had her vision checked? My mother’s old ophthalmologist evidently closed his own eyes during her exams since we just found out , new dr., she has no vision in one eye due to macular degeneration. She recently fell, broke her hip and was having problems using her walker. She has dementia but she also couldn’t see🙄!
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Well in recent days this is getting worse! In fact the other day my mom called the neurologist office on her own to see if she could get in sooner but they told her there were no openings. Her appointment is scheduled for March 26th. I was shocked she called the doctors office as she usually asks me to make those calls.

She didn't seem to have any acute physical stress that would warrant an ER visit, so I don't know what to do. The next day after she tried to change the appointment it seemed to get a bit better and we had dinner together and she seemed okay but more quiet than usual. Then yesterday she was back to telling me she "is sick" and it's all this balance stuff again. This is really starting to concern me. She just wanted to isolate by herself.

I know she doesn't have an UTI because she just finished a course of Bactrim that her foot doctor gave her (she had a neuroma removed and he gave that to prevent infection, but surely it would have covered any UTI)

I don't know what to do.
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Jannner Mar 9, 2019
Have you taken her to a primary care physician? I had a friend with Meneries ( May have spelled that wrong , probably 😉) . She had balance problems and Iir sometimes the vertigo made her feel sick. It’s an inner ear problem. Might be worth a shot til she can get into the neurologist.
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I've had balance problems for the past three years. Started when I was 61 1/2. It's accompanied by a few other issues including numbness in my face, dry mouth, chest pains and what a neurologist would later call a strange gait. Initially it was thought I had an abscess in my jaw from some very sloppy dental work. Then an infection in my sinuses. The doctors then decided I must have had a stroke. All these were ruled out by a succession of very expensive scans and fiber optic probing. After a year and a half of living with the symptoms and not having a diagnosis, a neurologist told me I had a brain tumor. Another brain scan ruled that out, so he settled on a diagnosis of Parkinson's. Meanwhile the cardiologist was preparing some risky invasive tests on my heart. Shortly before I was to start my treatment, I changed my primary care physician. The new doctor consented to the $50 Lyme Disease test I had been begging for since my symptoms begain. The test was positive. I have made some progress with the treatment, but some of the neurological damage is apparently permanent.

My point is, there are a lot of things that can cause balance problems. I wouldn't leap to the conclusion that it is dementia.
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BlackHole Mar 7, 2019
My goodness, jimbo. How disheartening that your 1st doctor was so slipshod. He did real damage. I hope you are on a good path now. Sometimes Lyme has a long recovery. (((hugs)))
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I had balance problem for at least five years, was taking
Prilosec, switched to Nexim ,. Then I read that those medications caused dizziness , Told my physician that I would stop taking those and switched to Famotodine, Within a week dizziness disapper,
I went back to Prilosec for a few days and got dizzy.
I am 85 have hip replaced last year, have bad knees can not walk too far, use walker
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Reply to truppecantele
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Could be positional vertigo, or fallen arches or just weak leg muscles. It would depend if the dizziness is in her head or balance problems coming from her feet and legs. Legs would feel like rubber.
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I appreciate all the responses, thank you.

I'm going to talk to my mom's neurologist and see if she can order PT sessions. I don't think the lamictal can be lowered anymore. Her old neurologist lowered it once already and wasn't comfortable going lower. It's really important that she not have a seizure. But the PT seems like it could be helpful, so I am going to ask about that and hope my mom cooperates.

Also the issue about her refusing to use a cane or walker is really starting to aggravate me. It's some kind of vanity thing where she doesn't want to look like an old lady. HELLO. You can't walk right! I keep telling her the last thing she needs is a fall but she won't budge!
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Angie6069 Mar 6, 2019
My mother is exactly like this about using her rolling walker. She has dementia and I think she sometimes either refuses to use the walker or forgets that she has to use it to keep from falling. Mom lives with us. She fell yesterday while not using her walker, and after a trip to the ER the doctors stitched her head where she had a gash on her right temple. I understand what its like to live a circus everyday. Praying your situation improves also.
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It's related to age. There are three basic ways to maintain balance. Visual, vestibular and proprioception. Visual is just well vision. Vestibular is your inner ear. It's kind of like a built in gyroscope. Proprioception is body sense. It's when you know whether your leg is straight out or at an angle for example. All 3 fade with age. You can generally get by with only 2. That's why the cops have you close your eyes during a sobriety test. It takes away one of them. The alcohol takes away another. So you won't do very well.

Vestibular system tends to be the one that fades noticeably. Unfortunately, the way people compensate is by looking down to see where they are going. This takes away visual as well since you really want to have your head up and looking at the horizon for that to work right. Then you lose your balance and fall.

There are exercises to retrain the brain to deal with a compromised vestibular system. One way is to rig someone up on a special treadmill and trip them. They learn rather quickly how not to fall. A gentler way is to teach them to look up when they walk to get visual cues. But that takes longer.
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Jimbosticks Mar 6, 2019
Learned a lot from your post. Thanks.
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My late mother, a person without dementia, listed to one side. The issue was corrected by obtaining a shoe lift to fit inside one shoe from her podiatrist.
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Reply to Llamalover47
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have the doctor check her blood pressure - laying down, sitting and standing. it is called postural hypotension or orthostatic hypotension. Gravity causes blood to pool in your legs when you stand. Ordinarily, your body compensates by increasing your heart rate and constricting blood vessels, thereby ensuring that enough blood returns to your brain.
But in people with orthostatic hypotension, this compensating mechanism fails and blood pressure falls, leading to dizziness, lightheadedness, blurred vision and even fainting.
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Time to talk to the Doctor.

I recently discovered that if I become dehydrated, I stumble and my balance is off. It's really easy to become dehydrated.

I'm 67 and I have trouble drinking my 8x8oz cups of water daily = 1/2 gallon. Since I am average and typical, dehydration is a big problem today.
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With my dad who has Alzheimer’s dementia, he was off-balance and started to shuffle instead of walking normally.
A spinal tap led to a diagnosis of Normal Pressure Hydrodephalus.
A shunt was installed but didn’t make much of a difference.
But...my friend’s dad who didn’t have Alzheimer’s had the same diagnosis and procedure and the results were terrific!
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CarlaCB Mar 8, 2019
I was also going to say you should have her checked for normal pressure hydrocephalus. That was my Mom's diagnosis, and she also had a shunt installed, and in her case it didn't help much. Except maybe it kept her problems from getting worse, including her cognitive decline. Her balance problems did not improve with treatment, sadly.
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In Medline Plus (www.medlineplus.gov), loss of balance is the first side effect listed for lamictal. However, there are frequently balance issues in the elderly, and for some, the cause cannot be determined. If no cause can be determined, if your mother is still able to do physical therapy, there are lots of exercises one can learn to try to improve balance. She should be able to get a P.T. prescription for balance exercises. If the cause is determined to be lamictal, given the her history with other unsuccessful medications for her seizure disorder, she may need to remain on the lamictal, although perhaps the doctor would want to try to lower the dosage. P.T. might still be appropriate. Ultimately, like many people, she may abolutely need to use a walker to avoid falls and potential broken bones. If the alternative were a wheelchair, the walker would probably not seem like quite so terrible! Nobody is delighted to need ambulation assistance, but safery is paramount!
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Any thought to hearing?

Urinary tract infection? Know it sounds weird but sometimes those cause people to fall backwards.

My dad is 101 and has complained of feeling this way, but he is active, had no falls. They've told him to get up slowly as a precaution if it is related to BP.

MD ordered a course of PT and it made no difference. We're considering Tai Chi.

Can you check with MD and see if you can do a drug holiday, wean off of it and see if makes a difference?
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Reply to gdaughter
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Sorry to hear this ,im 52 and i been having balance issues for 12 years keep falling over or backwards .. no answers to why
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My mom had balance issues and it turned out to be pancreatic cancer
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Would a walker help? Is she able to learn the new skill of using a walker?
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My dad’s balance problems have increased as his dementia’s worsened. I think it’s just one of the horrible morphological changes that come with the disease. He walks kind of hunched over, with his hips and knees bent and this gets worse as the day goes on. He also moves more slowly both as the day goes on as well as when he’s inundated with stimuli to process, like making a trip to the grocery store with my mom. His coordination is off and it’s a struggle to pour a bowl of cereal and carry it over to the kitchen table just a few feet away, he has trouble with fine motor skills such as cleaning and putting on/taking off his hearing aids as well as having decreased strength and trouble keeping muscle mass.
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Reply to Thisisb
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Dementia does affect the balance as it progresses. But do take her to a PT with orders from her physician for a mobility assessment. Will she at least use a pretty cane??
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Reply to Harpcat
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Along with this, Just Old age. Make sure she is Okay.
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Reply to Parise
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I could see balance being affected by dementia! Also consider her hydration, while you’re waiting anyway. I notice a marked difference when my mother hasn’t had enough water (a constant battle.) :( It literally shows in her posture, it may be specific to her diabetes 2 but worth a try.
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Reply to Zdarov
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Thanks all. She doesn't use a walker. Refuses. Her eyes and ears are fine, both have been checked.

It's either coming from the lamictal, or is stroke/dementia related. Three more weeks until her first neurology appointment in our area. I have so many questions written down. This is one of them.
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Reply to ExhaustedPiper
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Like rocket said, have her ears checked. Inner ear problems are not rare. And a good eye exam with an Opthamologist who is an MD. Not an Optometrist who isn't.
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Reply to JoAnn29
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Has her vision been checked lately? Mom started to have balance problems, got really shakey on her walker and didn’t want to try anymore, and unbeknown to us she had had an optic nerve stroke in one eye, which shot her balance off completely. Also you could have her ears checked as I’ve heard that some balance issues could be due to fluid levels in the inner ear.
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Reply to rocketjcat
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Have her evaluated by physical therapy/occupational therapy. Doctors office can assist with this. Does she use a walker? It might be time for one...be the squeaky wheel!
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