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Loss of Proprioception in Multiple Sclerosis

MS and Your Sense of Balance

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Updated December 05, 2008

How many of you have had this experience? You are passing your neuro exam with flying colors, proudly touching your nose with alternating fingers and walking heel-toe-heel in a perfectly straight line, then comes the test you know you will fail. You are asked to place your feet together, stretch your arms out in front of you and close your eyes. Yup, there we go -- you're almost toppling over. What you're experiencing is known as Romberg's sign, a loss of proprioception.

What is Proprioception?

Put simply, proprioception is the sense that tells us where we are in space. It is based on sensory input from the joints and muscles. It is the awareness of our posture, weight, movement and position of limbs, both in relation to our environment and in relation to other parts of our bodies.

Propioception has been called the "sixth sense," but it is rarely referred to because it is intact in most people, so most people don't really think about it. In addition, loss of proprioception is much more vague than, say, loss of sight or hearing.

I became intrigued with the idea of proprioception after failing this part of my neuro exam repeatedly. I found this interesting account of a man who lost all proprioception following a viral infection and learned to compensate for it with visual cues (published in the American Psychological Association's APA Monitor): Why can't this man feel whether or not he's standing up?

How is Proprioception Affected in People with MS?

MS slows down communication between the central and peripheral nervous systems through a process known as demyelination. As proprioception involves instant and coordinated communication between these systems, MS can leave us a little less "in touch" with ourselves and where we stand, so to speak.

I have found, however, that if I practice repeatedly and know it's coming, I can stand still and close my eyes and prevent myself from swaying (at least I think I am not swaying).

Source:

Lanska DJ, Goetz CG. Romberg's sign: development, adoption, and adaptation in the 19th century. Neurology. 2000 Oct 24;55(8):1201-6.

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