Skip to Main Content

We have a new app!

Take the Access library with you wherever you go—easy access to books, videos, images, podcasts, personalized features, and more.

Download the Access App here: iOS and Android

Dysequilibrium is the sensation of falling or imbalance associated with difficulty walking or standing and can arise from abnormalities of the brain, cerebellum, spinal cord, or peripheral nerves. Common causes include Parkinson disease, normal-pressure hydrocephalus, cerebellar degeneration (eg, alcoholic cerebellar degeneration), cerebellar stroke, vertebrobasilar insufficiency (VBI), vitamin B12 deficiency, tabes dorsalis, diabetes mellitus, and multiple sensory deficits. The cranial nerve, cerebellar, gait, and sensory exams may provide critical clues that help focus the diagnosis. Gait disturbances may suggest Parkinson disease (shuffling gait) or cerebellar disease (wide-based gait). Stocking glove sensory deficits are typical of diabetic neuropathy, whereas loss of proprioception suggests posterior column disease (ie, vitamin B12 deficiency, tabes dorsalis, and some compressive spinal lesions). A diagnostic approach is illustrated in Figure 14-6.

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.