Multiple Sclerosis and balance, vertigo and nausea


Multiple Sclerosis is an autoimmune disease in which the immune system attacks the productive covering of nerves in the central nervous system. That can affect your brain, spinal cord and optic nerves and cause a host of different symptoms - physical and emotional.

Mood swings, tremors and overactive bladder are just a few of the very common symptoms associated with the condition. But many people living with MS also experience frequent bouts of vertigo and dizziness, which then leads to nausea.

It’s very common to experience fleeting moments of vertigo and dizziness. Like every symptom, how MSers are impacted by dizziness is very individual and how long episodes last, what’s causing balancing difficulties and remedies varies from person to person.

Balance

Many MSers struggle with balance from time to time. That’s because MS can affect the way our brain receives and replies to information. Messages being passes inside the brain can be disrupted or delayed and that affects the way it processes balancing information - leaving us vulnerable to being shaky on our feet or misstepping.

Our balance system is made up of three parts:

Input: vision, inner ear and sensory changes. What we see and feel provides our brain with information about our surroundings. If you’ve got double vision, for example, you may struggle to move effectively. The inner ear relays information about the angle and position of the head and if the connection between your inner ear and brain is disrupted, that can have a significant impact.

Processing: nerve damage can affect how well our brains process information. If the damage is in the cerebellum (the bit that coordinates voluntary movements) or brainstem, that can cause things like vertigo and nausea.

Output: the way your body reacts to messages can be affected by MS if instructions aren’t being properly relayed. You might feel muscle weakness or stiffness or find your control over your limbs isn’t as strong as before.

Of course, not everyone with MS will experience balancing issues because of MS damage. Sometimes feeling unstable can be down to other things.

MS-related causes:

  • Rise in body temperature
  • Relapses
  • Fatigue
  • Inner ear infections
  • Chronic vertigo
  • Medications

If you think there’s a chance that your medication is causing unpleasant side-effects, chat to your MS team who can review your prescriptions.

There are a number of ways to improve your balance:

  • Balancing exercises (check out this super quick exercise video from the MS Society)
  • Physiotherapy
  • Aids and equipment (talk to your MS team about having occupational therapy or an assessment to make your home and workplace easier to navigate)
  • Functional Electrical Stimulation (a medical kit that sends electronic signals to your leg muscles. Talk to your MS team about whether you’re eligible)
  • Fampridine (a medication which helps roughly a third of people who take it and can speed up your walking by 25%)

Dizziness and vertigo

It’s common for MSers to feel lightheaded but occasionally, people can feel like they or their surroundings are spinning. That sensation is a condition called vertigo. You can experience vertigo without having MS - usually as a result of inner ear infections and migraines. But vertigo can happen as a result of MS damage. Lesions to the pathways that coordinate visual and spatial input to the brain can result in feeling spatially out of control.

Vertigo isn’t permanent - it’ll come and go but one in three people with MS will be affected by it at some time. It’s really important if you do experience vertigo, to make sure that you see your GP. Vertigo can be caused by unrelated issues so don’t ignore it or chalk It up to being just MS.

If you have a vertigo episode:

  • Sit until it passes
  • Try to keep your head and body still
  • Dim the lights
  • If it happens at night, sit up in bed and turn on some soft lighting. If it returns when you lie back down, see if you can sleep in a reclining chair

How to treat vertigo:

  • Physiotherapy
  • Acupuncture
  • If you experience episodes regularly, keep a diary of when it occurs and show it at your next MS team meeting. Your MS nurse can help you to work out how to avoid them from happening
  • Stay active - exercise may help to reduce symptoms
  • See an occupational therapist so your environment is as safe as possible
  • Medications like antihistamines, anti-nausea drugs and steroids can help

Nausea

In and of itself, nausea isn’t a common MS symptom but it can be caused by these more common afflictions. Dizziness, vertigo and imbalance can make us feel sick - particularly if it goes on a long time. Medications can also cause nausea. We know that feeling sick is a possible side-effect of drugs like ocrelizamab, dalfampridine, dantrolene, anti-fatigue meds like fluoxetine (Prozac) and anti-depressants like sertraline.

To reduce nausea, you need to work out what’s causing it. Use the steps above to get a hold on any balance, vertigo or medication issues you may be having.

If you are living with balance, dizziness, vertigo or nausea, it’s always worth talking to your GP and MS team. Just because these symptoms are relatively common, that doesn’t mean that they can’t be treated or improved. You don’t have to live with uncomfortable or alarming simply because you think they’re par for the course.

If you live with MS or are caring for someone with the condition, think about joining our free myMS support programme.

Information contained in this Articles page has been written by talkhealth based on available medical evidence. The content however should never be considered a substitute for medical advice. You should always seek medical advice before changing your treatment routine. talkhealth does not endorse any specific products, brands or treatments.

Information written by the talkhealth team

Last revised: 11 June 2020
Next review: 11 June 2023