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Questions posted in the
Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.
Question Title: Multple SclerosisForum: Neurology Forum
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I am a 43 year old woman who was initially diagnosed with MS in 1981 after eight years of recurring bouts of optic neuritis. The diagnosis was arrived at via a positive spinal tap. Throughout the intervening years I have continued to experience relapses and remissions, primarily sensory: ON, nostagmus, double vision, fatigue, leg jumps, feelings of hot/cold and the like. Each time I was treated with Prednisone given orally. My most recent bout with ON left me with 35% vision in my right eye and I was told this was caused by the Prednisone. I have since changed neurologists. My new doctor questioned 1)my original diagnosis, 2)could 'see' nothing wrong with my right eye (though previously diagnosed by a retinal specialist as well as an opthalmic-neurologist) and had me take an MRI. The MRI revealed that I had "silent lesions clustered around the ventricles". Given this background, I hope you could answer some questions for me: Optic neuritis occurs in about 25% of all patients with MS. The symptoms that you describe as well as the remitting/relapsing course is suggestive of MS. On eye exam there may be swelling of the optic nerve head, however, this only occurs in 50% of patients. Atrophy may also be seen. About one-third of patients with optic neuritis recover completely, the rest have some degree of visual impairment. A good test to evaluate for Optic neuritis would be visual evoked potentials ( which would show slowing in the affectd eye). The current recommendation for treatment of ON is high dose IV methylprdnisolone. "Silent" lesions are those areas seen on imaging studies (mri) that do not have clinical (neurological) signs currently associated with them. If you are interested in getting an evaluation at CCF call 1-800-CCF-CARE. Good Luck.
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