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I keep falling. Any idea what could be causing it.


KidsHappen
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At least seven, maybe as many as ten times in the last month I have fallen for no apparent reason. No dizziness, tripping, spilling or any other obvious reason. Not even any warning. I am not aware of the fact that I am going to/am falling until it has already happened so I can't even brace myself for it. At least twice I have face planted, a few times I have hit my head and a few various other contutions. My blood pressure and sugar are good. I have already had a brain MRI which was basically normal. Could this be something neurological? Any other ideas? I am really starting to worry I am going to break a bone or something.

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What are you doing when this happens?  Walking?  Standing still?  Shouting or not?  Singing?

If you’re standing still, you might need the help of leg motion to keep your blood supply to your brain going.  I have heard that that is assisted by a little salt, like, a pinch of salt in a glass of water.  Or you might be a bit dehydrated.  I used to get this when I was singing hard while standing, and I found that I could usually prevent it by drinking about a pint of water at intermission, something I had been avoiding because the bathroom lines are significant at concerts, and the choir doesn’t usually have priority so using the facilities can be iffy.  

If you’re walking, you might have tripped, or you might have drop foot—when it’s subtle you don’t necessarily identify it as such.  Or you might be dehydrated.  Or you might be responding to an altitude change that usually doesn’t bother you, but in combo with exertion or dehydration or both it overwhelms you.

Is it possible that you have mild, almost imperceptible vertigo?  That can certainly contribute.  You can tell by standing up and shaking your head hard.  If you get dizzy, you might have some degree of vertigo.

When I had this, I wore a heart monitor for a month to rule out heart issues, and then when I passed that test I started unpeeling the onion in the ways I mention above.  However, in my case I could feel the imbalance (not really dizzy, but not normal either) before the fall, and if I laid down flat I would not lose consciousness.  

Epilepsy or other cause of absence seizures can show up this way also.

Edited by Carol in Cal.
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Have you been observed falling? What has anyone noticed if so? I had a period where I was falling a lot with MS, but I always new it was coming. I was having obvious balance issues. I think I would be more concerned about seizures. I think you would have notice with POTS too, but not having it I don't know...

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Investigate functional neurological disorder. It can manifest with multiple physical symptoms, and falling is one. It’s typically diagnosed by ruling everything else out, so you need to get the full Neuro workup. It can be tough to find good treatment, but I have recommendations if this turns out to be your situation. 

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1 hour ago, Laurel-in-CA said:

Falling unexpectedly was one of the early signs of Parkinson's for my mom. But as you've had an MRI that may already have been ruled out.

Unexpected falls was one of the early symptoms of Parkinson’s for me. 
I was diagnosed with young onset Parkinson’s a year ago. Prior to diagnosis, I would fall for no reason. It was like my brain blanked out.
OP: Have you seen a neurologist? If not, I would want to see one. Mine ordered a battery of tests to rule out seizures, sleep apnea, etc. A PD diagnosis is more process of elimination  it won’t show up on an MRI or CTscan in the early stages  

Best wishes. 

Edited by GoVanGogh
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Yes, I would want to see a neuro at this point. Not being aware that you are falling makes me think of seizures also, but a neuro is a good next step even if it's something else. Do not let your PCP put you off or drag this out. 

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Seizures would be my concern.  You desperately need to run, not walk, to a neurologist.   A neurologist will know what to ask and how to proceed (an EEG would be top on m list).  Even if it turns out not to be neuro related, that needs to be ruled out by a neurologist.  Good luck to you.  This is terrifying and I hope you get good answers soon.

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22 hours ago, BaseballandHockey said:

My mother had something like that, a series of sudden falls, including several that led to broken bones.  It was something to do with low sodium in her blood?  I don't know the details, but they gave her something that fixed it.

I looked back at the emails from my mom when this was going on to jog my memory, and the issue was with her kidneys removing too much sodium.  So, while I agree that being checked out by a neurologist is a good idea, in her case the solution came from a nephrologist.  

I'll also add that my mom has neuropathy in her feet, and Parkinsonian type tremors, that are not actually Parkinson's.  She's fallen from those causes too, but in those cases she can feel herself tripping or losing her balance.  With the sodium, she'd be steady on her feet and then suddenly just go down, and be confused as to how she ended up on the ground.  Any break in consciousness was brief enough that people who saw her fall were not aware of her being unconscious.  

I'm not saying this is it, just that it's probably good to look for neurological causes, but not to limit yourself to neurological causes, if that makes sense.   

 

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Neurology referral is a good idea, but if you haven’t already had a basic work up, you should still also see your PCP, especially if it might be awhile before you can get into a neurologist.  Basic work-up can check for metabolic abnormalities (through blood tests), and get a cardiac work up started (EKG, wearable heart monitor). If you’ve already had all that, then yes, definitely Neurology. (Or you can run them in parallel)

 

 

Edited by JHLWTM
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Low sodium, hyponatremia, can cause seizures if it falls low enough. It’s usually seen in older people but certain medical conditions and medications can cause it as well. There could be other symptoms as well but you might be healthy enough that the only symptom is a seizure. It’s not too difficult to diagnose. Just a blood test.

https://www.mayoclinic.org/diseases-conditions/hyponatremia/expert-answers/low-blood-sodium/faq-20058465

If you do have it, it’s important to slowly bring levels back up to normal because a sudden change can lead to something called osmotic demyelination syndrome. I was just reading about ODS the other day and this occurs most often when a sodium imbalance is corrected too quickly, such as with an IV. Otherwise, it’s rare. I’m not 100% sure, though.

https://medlineplus.gov/ency/article/000775.htm

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23 minutes ago, BeachGal said:

Low sodium, hyponatremia, can cause seizures if it falls low enough. It’s usually seen in older people but certain medical conditions and medications can cause it as well. There could be other symptoms as well but you might be healthy enough that the only symptom is a seizure. It’s not too difficult to diagnose. Just a blood test.

https://www.mayoclinic.org/diseases-conditions/hyponatremia/expert-answers/low-blood-sodium/faq-20058465

If you do have it, it’s important to slowly bring levels back up to normal because a sudden change can lead to something called osmotic demyelination syndrome. I was just reading about ODS the other day and this occurs most often when a sodium imbalance is corrected too quickly, such as with an IV. Otherwise, it’s rare. I’m not 100% sure, though.

https://medlineplus.gov/ency/article/000775.htm

I have this and feel awful most of the time from it, but no seizures (yet).  I haven't been hospitalized due to low levels, but close.  

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On 2/3/2021 at 1:33 PM, KidsHappen said:

At least seven, maybe as many as ten times in the last month I have fallen for no apparent reason. No dizziness, tripping, spilling or any other obvious reason. Not even any warning. I am not aware of the fact that I am going to/am falling until it has already happened so I can't even brace myself for it. At least twice I have face planted, a few times I have hit my head and a few various other contutions. My blood pressure and sugar are good. I have already had a brain MRI which was basically normal. Could this be something neurological? Any other ideas? I am really starting to worry I am going to break a bone or something.

My mom fell multiple times February of last year, before she or I knew about Covid.  We are absolutely convinced she had Covid and the falling was a symptom of it.  Could you have been exposed?

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Does it happen soon after standing up?  If so, you could be blacking out.  I used to black out very quickly if I stood up too fast.  It doesn't happen anymore, but I don't know what changed.  It happens to some of my kids now, so at least part of it is genetic in our family.  But it could be an indication of low iron, low salt, dehydration, etc.  

Can you figure out a pattern?  Does it happen more often during certain times of the day?  If you haven't eaten for awhile?  If you're tired?

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