Imbalance without Vertigo

[omar.sharifa]

a patient 30 years old work as sports teacher in high school ,
before 2 months he suffered from imbalance without vertigo ,
he took Betahistine hydrochloride for one month and no benefit ,
he registered to come to my clinic next week

so my question is what will you do for that case ?

in his case history no chronic diseases like blood pressure nor diabetics

Thanks

[AcousticS]

A few days ago I just read something interesting.

Link: http://www.pponline.co.uk/encyc/0505.htm

Imbalance without vertigo, comes especially in front of athletes.

It is a muscle imbalance.
Screening test and background are from the physiotherapy.

[omar.sharifa]

thank you very much

[AcousticS]

No problem.
When I read this, I thought to myself, is to be very rare.

Then I read your question.

Cool

Otherwise I would have had no idea.

[Cochlear]

Imbalance is usualy without vertigo.
Vertigo is usualy otogenic manifestation (ofcourse could be neurogenic), but
imbalance is almost exclusively neurologic sy.

First, you should ask what kind of imbalance is that:
1. objective, when walking he goes to one side
2. or subjective: the patient thinks he might go aside but actually he goes straight

First needs neurological examination
Second usually psychogenic in nature

Anyway the minimum you should perform:
Romberg test
Compass (or tandem) walk
head impulse test