Neck Issues After Double Vision

[cakencoff]

I am a 35 year old female.

July 2006 I came down with sudden onset diplopia (it was a very hot day and I had been swimming/diving). The double vision lasted about 8 days but I was left with morning sickness (was not pregnant!) and motion sickness. Dramamine helped until about 6 weeks later when my eyes (convergence) cleared up completely.

I had a normal MRI. I had bloodwork, which came back overwhelmingly normal. They tested for lupus, sediment issues, diabetes, thyroid, cholesterol, b-12 deficiency, prolactin, inflamation (inflammation), blood cells, etc.

I saw a neurologist who thought if anything it would be myasthenia gravis, but most likely a virus. She had me get a test for m.g. anyway, which came back normal. She was pretty firm that it was not MS.

Since August, I've been feeling pressure in the lower back of my head, which has mostly cleared up. Now, I mainly have neck soreness and crunchy sounds when I turn my head (never had this before!). And pressure, if any, comes up on the sides of the nape of my neck. Sometimes, I feel it vibrating or buzzing very slightly at the back of my head. I also had Benign Positional Vertigo for a little over a month back in September/October whenever I layed down on my left side. For a very brief period in October, I felt tingling in my right arm and leg. I'm actually feeling pretty good other than my neck.

So, normally, I would wait and see. Maybe practice stretching exercises, etc. But I'm newly pregnant and am worried that maybe something is still going on. Are there any tests that I should be given with this history? Do you think I should be tested for Lyme Disease? (I went camping the first week in July and came down with double vision around the 22nd.) And are there really viruses that inflict such things?? Thank you.

[Kevin Pho, MD]

You have a pretty comprehensive evaluation for your symptoms.  

An MRI of the cervical spine, as well as an MRA of the neck vasculature can be considered to further evaluation the symptoms.  

Also, with the brain MRI, you want to ensure that the posterior circulation was evaluation - since this may lead to some of the symptoms you describe.  

A virus is possible.  This would be an uncommon presentation of Lyme disease.

A referral to a ophthalmologist or another neurology opinion can be considered as the next step.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_

[just don]

Cakencough,
  PLEASE e-mail me  for a personal story similiar to yours in way too many respects!!   saramy 'at' ptcnet.net   Obviously you need to put the proper a for e-mail where the 'at' is ( done for spamming purposes)

[Truthfinder]

Well, I don't blame you for wanting to know what is going on.  Obviously, something has changed for you since July.

I sure would not rule out some kind of Tick Borne Disease.  I have some strange eye problems and my neck is a real mess, and I found out last year that I have Lyme Disease after at least 20 years of odd, seeminlyg unrelated symptoms.

As you probably already know, the tests for Lyme Disease and some other TBDs are notoriously inaccurate, so getting a diagnosis can be very difficult.  

The best thing I can suggest is that you stop over at the LymeNet Flash Discussion if you wish to pursue the Lyme idea.  There is much information there and people who can help you find what you need.

I'm not trying to promote another forum, but I don't find much here on TBDs.

[minimax]

I have had PRECISELY the same symptoms which began in June 2005.  I've probably had far more tests than you (given the year longer duration), and all yield healthy results.  I now have face pains and tremors on the right side of my head, again affecting my eye (although no diplopia)leading to trigeminal nerve tests, more MRIs, etc.  Everything I read points to Lyme (Lyme Encephalopathy?) - along with the fact my problems also started in the summer, I spend time in tick country (east end of Long Island) and I have a lot of outdoor activities.  Does anyone have suggestions for alternative / better tests for Lyme?  dmax01 at optonline dot com

[minimax]

Where do the people responding to this posting live (are there any parallels)?

I live in New York City and East Hampton NY.

[suellis]

Everyone experiencing head and neck difficulties ranging from vertigo to arm/shoulder pain must have these areas MRI'd for related cervical herniations.

I want to also stress that I became ill in 1999 with viral meningitis and again in 2003. Since then I've had severe spinal pain, headaches, generalized fatigue, tachycardia, anxiety (pain related), vertigo, shoulder blade pain, arm wrist pain (required carpal tunnel release), etc....

I was only 26 at the time and had just been married when I first became ill in 1999. I work for a federal agency and had traveled to the beautiful state of VA the last week of August which is why the ER attending/admitting doc's instantly found the meningitis.

Problem is they never looked any further. Now 7+ years later I've had a fusion in the lower back L5:S1 an injury resulting from a spinal tap via incompetent ER doctor! I then had a left arm carpal tunnel release after severe throbbing L arm, shoulder, collarbone neck pain. The release revealed a congenitial BD known as a persistent median artery which runs parallel to the median nerve. It's also an extra artery with an extremely strong blood flow and pulse. Visited many cardiologists and vascular surgeons who all suggested cervical rib removal to provide more space for the artery as it traveled down my L. arm.

Arm improved for almost a year after the CT release but then the meningitis came back and intense neck pain. My attending Neurosurgeon (has performed all surgeries) put me through an intense routine of cervical blocks (occipital nerve, sympathetic nerves, C3:4 to C7:8 blocks, trigger point injections, etc.) After no improvement an MRI revealed a bulge at C5:C6 obviously this would be some of the problem so we elected to proceed with another fusion, this time with cadaver bone implantation.

I was better until I returned to work and realized I couldn't lift anything. Since I'm female, early 30's, small framed and approximately 115 lbs I scored myself a permanent 5 lb lifting restriction, this includes pushing, pulling, etc. This was to preserve my lumbar and cervical spine fusions. I did almost a year of PT for the cervical spine and upper body. All it did was give me great looking arms and uncontrollable nausea in addition to new trigger points.

During November of 2006 (last fall) I decided to follow up with an infectious disease doc about the Viral Meningitis one more time. I have a wide science background as my place of employment is a federal scientific agency. To no surprise I tested positive for exposure to West Nile Virus. My IGM titer was way above the highest convalesent reference range which represents current/recent infection. The doc reviewed my labs from both meningitis spinal taps and provided add'l insight to support the 1999 case as the initial source of infection.

I also have mild mycoplasma pneumonia, mono and Epstein Barr (Chronic Fatigue Syndrome) as a result of all this and the large amount of injected steroid procedures restricting my immune system. All other labs checked out OK, no hepatitus (hepatitis), no kidney issues and my heavy metals were A-OK. This has been no picnic so I strongly urge everyone to keep pushing the physicians for tests until you receive answers. Since little is known of the long term affects from WNV only time will tell. It does however cross over the CNS barriers via spinal cord and can lead to MS or other CNS related disorders later in life.

I wish everyone wellness and good luck. Always keep a good neurologist and neurosurgeon in your treatment seeking regeime as they know much more about the bodies nerves (CNS) than ortho doc's!
Thanks for listening :0)

[Truthfinder]

Minimax, the Igenex (California) Western Blots are the best mainstream Lyme tests out there, followed next by MDL (In New Jersey, I think).  Even these labs can give false negatives, though, because sometimes there just aren’t enough antibodies in the blood.  There are number of reasons for this.  And the longer you have had Lyme, the higher the chances are that you will test negative.

I used an “alternative” test called the Q-RIBb test from Bowen Research.
http://www.bowen.org/NewSite/LymeDisease.html
This is an entirely different type of blood test.  Bowen Research is in a state of transition, however, and I’m not sure that they are still offering the Q-RIBb test.  You would have to contact them to find out.  And I think the Q-RIBb test is actually illegal in NY!!  So, I don’t know if this would be an option for you.

And by the way, I live in Colorado where there is no Lyme Disease (yeah, right).  Funny thing, though, my veterinarian is finding Lyme in dogs that have never been out of the area.  You can get Lyme ANYWHERE, and there is evidence that Lyme can be transmitted person to person, but no proof yet.

Suellis, you are right – we have to keep pushing our docs for answers.  My docs were happy to give me the diagnosis of Fibromyalgia with degenerative spinal issues.  Nobody ever thought to test me for Lyme, including the Mayo Clinic in Arizona.  I had to figure it out myself.

Tracy

[homeschoolmommy]

I had to write, I even registered to get back to you! I have all those symptoms at one time or another. I HAVE a positive lyme test. So, ignore the advise that Lyme doesn't present that way. AND, get on preg safe antibiotics IMMEDIATELY. I past this down to my daughter while pregnant because I didn't know I had it. Go to Lymenet to get a referral for a Dr. in your area. They have to be what is known as Lyme literate or you will get faulty advice. GoodLuck!!

[suellis]

Thanks Truthfinder. I agree with you and the Schoolmommy posting after yours. Problem is if you elect to test for Lyme you should also test for West Nile Virus. The two have lots of similarities with respect to symptoms, illnesses, etc..Both can be passed on during pregnancy to fetus. Sad but not enough infectious disease doc's out there researching, and practicing proactively. My Internal Med. Doc could have ordered the same lab test but refused for two years straight. She believed I couldn't possibly have Lyme's or WNV living in Indiana? Totally dismissing the Viral Meningitis I had twice (99 & 03). As if I don't travel? Both of these illnesses are insect borne. Be persistent and don't give up until you get answers and your health improves. IT'S YOUR LIFE AND YOU ONLY GET ONE! ;o)

[skeeterbit]

Thank you for posting your comments / problems with West Nile.  I contracted WN in 2002 in Louisiana and am still having lots of difficulties. There is so little known about the long-term effects and it seems as though the states and CDC aren't too interested in following-up on the victims.  My problems include some of the following:  fatigue, muscle pain, muscle weakness (legs and arms), difficulty walking, loss of some long-term memory, difficulty with short-term memory (forgetfulness), depression, anxiety, cylces of sleepiness, and more.  I was 52 and in good health.  Had I not done research on the internet and furnished my doctors with WN information, there is no telling how much money I would have spent or how much torture I would have been put through - just because they didn't know.  People need to research their medical problems so they can intelligently communicate with their doctors.  Doctors are human, too.  

Again, thank you for sharing your experience and letting folks know that WN can affect some people for periods longer than a few weeks or a year.