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Questions posted in the
Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.
Question Title: MS and exerciseForum: Neurology Forum
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| A couple of weeks ago, after a week long headach that turned into eye pain and loss of vision. I went to my family doctor. He referred me to an opthomologist who said I had an inflamed optic nerve. The opthomologist booked an appointment for me to visit a neurologist but the appointment is not for another 3 months. I did some research on the internet and quickly discovered the link between ON and MS. This has me very upset since I have been bothered by a buzzing sensation in the back of my legs which started at about the same time. This buzzing gets better and worse throughout the day but is particularly bad when I'm in the shower or when I exercise (especially if I bend froeward). Obviously I can't stop bathing but should I stop exercising? It doesn't hurt, it's just very annoying. --------------------------------------------------------------------------------------------------------------------- Hello Kristine!! Optic neurtitis is inflammation of the optic nerve, which connects the retina of the eye to the brain and when inflammed, may produce eye pain, especially with eye movement, loss of vision, blurring of vision, fading of vision, or "washing out" of colors where everything appears pale or requires brighter than usual light to define the details of. Optic neuritis can occur in isolation, but may be the first sign of multiple sclerosis. To diagnose multiple sclerosis, one must have at least two attacks of neurologic disease separated in space (meaning they occur in different anatomic parts of the nervous system) and time (occuring at least a month or so apart, more typically many months or years apart). A recent large research trial called the optic neuritis treatment trial (ONTT) demonstrated that the best treatment for optic neuritis associated with the smallest short term risk of developing multiple sclerosis was intravenous methylprednisolone (Solumedrol), a corticosteroid (cortisone-like antiinflammatory drug), and that treatment with oral (pill) corticosteroids alone (without IV drug preceeding) actually may slightly increase the risk of developing multiple sclerosis. The eventual risk of multiple sclerosis can be guestimated by obtaining MRI scans of the brain and/or spinal cord. If lesions typical of those for MS are seen elsewhere, the risk is high, whereas if only one or no such lesions are seen, the risk is lower. There is a phenomenon known as Lhermitte's phenomenon, in which bending the neck back produces a shocklike sensation throughout the body. It is caused by inflammation of nerve tracts in the spinal cord called the posterior columns. Other lesions in the spinal cord can cause abnormal sensation, strength, or corrdination in both legs, both legs and both arms, or one leg and arm on the same side of the body, or more unusually a combination thereof. Other tests that in certain circumstances may help diagnose multiple sclerosis (or the lack thereof) include lumbar puncture (spinal tap) to look for myelin proteins and special immunoglobulin proteins in the spinal fluid that are often (but not uniquely) seen in MS; visual and somatosensory evoked potentials. Please remember that the information we provide on the forum is intended for general medical informational purposes only, and that the actual diagnosis and treatment of your specific medical condition should be strictly in conjunction with your treating physician(s). We hope you find the information helpful. If you would be interested in an evaluation at the Cleveland Clinic, we do have the Mellen Center, one of the largest centers devoted to the diagnosis and treatment of multiple sclerosis and related disorders like optic neuritis in the world. Our number is 1-800-223-2273 (ask for Mellen Center appointments).
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