What is cause of pure balance in ALS?

[jethro]

my ALS started with poore balance. i tripped, fell etc. no power loss at all. emng was ok, mri ok, nobody knew.
to be honest after few years, they looked at few main muscles in 2016 which were ok.
but i fell all the time.
can it be:
1. certain group of muscles are affected, so balance is affected but we still dont know which muscles cause instability untill neuro puts a needle in a muscle that is affected?

i have mixture of affected muscles: most affected are right calf (peroneus + tibialis), distal muscles, and
left quadriceps, proximal.

2. foggy brain, bad posture as a result, etc etc...
3. something else?

 

[Nikki J]

Certainly all my falls and balance issues relate to muscle weakness. A fall has brought new areas of weakness to my attention more than once

Core weakness is also a contributing factor if a PALS has that

Aside from that do I recall correctly you had a traumatic brain injury in the past? If that is so there may have been some residual effects that you were able to compensate for until ALS entered the picture

 

[jethro]

o, nikki, it seems that no doctor is efective until he starts to suffer from the illnes that he cures.
i did not understand what is the real cause for falls in ALS. what causes poore balance? muscle weakness? that is not my case. when i was strong, i had a poore balance, i fell 2-3 times daily, at that time MRI, blood, CT, EMNG, 3x neuro, EEG, SSEP, ORL, all markers, internist, glands, ofthalmologyst, dont know what else, - everything perfect. then they said: dont know what is going on with you, last thing what MIGHT be is a rare kind of sifilis. i was negative.
i allwas mention my severe brain injury 20 yeaars ago and kind of dizzy that follows me since then, but it was maybe 2% of dizziness i have now.
finally, one neuro said that something in my brain (concentration, focus on other things etc) causes my brain to be exhausted and that might be a reason for disbalance.
i still have enough power in my limbs, walk alone with no afo, but no more than 200m at once. i have to concentrate when i walk. if someone calls me, it is possibly
that i will fall if i turn arround.
so, power loss is not cause for my (dis)balance, but it seems that i will meet that cause also, very soon :-(

 

[preacherman]

Just my experiences...

No big history here for now, just to say that the troubling issues that made me start the diagnostic process were mainly balance, brain fog, occasional aphasia, unsteady on my feet.

The neuro who finally got the ball rolling and ordered an EMG was actually looking for neuropathy. She was far more interested in the NCV part.... which, to her surprise, was clean.
The EMG revealed the secret.

To this day, almost three years later, even though strength and endurance is starting to be a bit of an issue, it is balance and disorientation that causes most of my falls.

Neuro had all kinds of reasons and ideas about how muscle weakness could be causing the disorientation but... I think they are all just guesses.
To me, if something is killing motor neurons, or destroying their pathways, why would it be unreasonable to believe that whatever it is, is destroying other pathways?

They can do MRIs PETs, etc.... but they still cannot actually see all the little electrical connections.

 

[KarenNWendyn]

Balance is a complex phenomenon that is influenced by many different systems in the body. These include proprioception (which comes from a different part of the brain than the frontal cortex), the inner ears, vision, sensory input from the feet, and finally muscle strength. Also, if someone is dehydrated or has autonomic nervous system dysfunction, that can affect balance.

ALS affects the muscle strength. As Nikki says, both weakness in leg muscle muscles and core can impair balance. The lower leg muscles, in particular, are constantly contracting to maintain stance, and will be affected by ALS.