Falls in Multiple Sclerosis, before and during treatment.


Falls are very common in Multiple Sclerosis; they are likely to be multifactorial [Cattaneo D, De Nuzzo C et al., (2002) Risks of falls in subjects with multiple sclerosis. Arch Phys Med Rehabil. 83 (6): 864-7.] They may result from weakness, from loss of sensation and proprioception, from vertigo. A prolonged reaction time may make the fall awkward, and prevent a controlled landing. And, until it is corrected, relative Vitamin D deficiency and osteoporosis may increase the risk of fracture.

People with MS who are making good progress on treatment also remain susceptible to falls; paradoxically the reduced reaction time and the increasing strength and improving mobility may lead to risk-taking. Not all modalities return at the same rate, and, during this period of subtle change, falls through inadvertence are a risk. Also, some persons may well have C. pneumoniae infection in the inner ear; destruction of the organism may release endotoxin, which, until it is removed, may be expected to cause vertigo. (This is speculative, but it seems reasonable: endotoxic inner ear damage can occur after meningococcal meningitis.) The pattern is that of labyrinthitis; sudden turning of the head, particularly on looking up, results in rotational vertigo, which can result in a fall.

Don't rush, even if late. Use handrails. Stairs are the most dangerous things in the house. Don't let yourself be distracted while climbing or descending them.

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This page uploaded 16th September 2006