Any condition that can cause dizziness also can cause imbalance. There are, however, a few conditions that primarily cause imbalance, but do not usually cause dizziness or vertigo.

Parkinson's Disease:
Parkinson's disease (PD) often causes severe imbalance. This typically occurs because patients with this disease have postural reflex abnormalities. Normally when the body sways in one direction, a reflex occurs that causes muscles to contract and the body sways in the opposite direction in order to prevent a fall. Patients with PD have problems with this reflex and when they began to sway they often continue to sway in the same direction until they fall. PD usually is diagnosed with a thorough neurological examination. Oculomotor testing also can be useful in making the diagnosis.

Peripheral Neuropathy:
Peripheral neuropathy is a disease that affects the small nerve endings throughout the body. Usually the small nerves in the feet and toes are the first to be affected and this causes numbness in the feet. Patients with peripheral neuropathy have imbalance because they cannot feel the floor beneath their feet. This imbalance can be especially severe on unstable surfaces and when the patients attemps to walk in darkness, as visual cues are important to these patients. Peripheral neuropathy can be diagnosed with a detailed neurological examination and nerve conduction studies.

Stroke:
A stroke is a scar in the brain caused by absent or decreased blood flow. Usually this occurs because of narrowing of an artery or a blood clot that goes to the brain. If a stroke happens to occur in an area of the brain that is important for balance (i.e., the cerebellum or brain stem), severe imbalance can occur. Stroke is most often diagnosed with a careful neurological examination and magnetic resonance (MRI) or computed tomography (CT) imaging.

Multiple Sclerosis:
Imbalance is very common is patients with multiple sclerosis (MS). In MS, the insulation around brain and spinal cord cells is defective. The lesion in the brain or spinal cord caused by the defective insulation is called a "plaque." If a plaque occurs in the regions of the brain responsible for balance such as the brain stem or the cerebellum, the patient may experience severe imbalance and ataxia.

Cerebellar Degeneration:
This is a disease that causes shrinkage and dysfunction of an area of the brain called the cerebellum. The cerebellum is important for coordinating the movements neccesary to maintain balance. This diagnosis can be made by examination, MRI, and oculomotor testing.

Poor Vision:
Vision is very important for balance. Conditions causing poor vision such as cataracts and macular degeneration can lead to imbalance, particularly in patients who also have any of the conditions listed above.