Is this TIA/palsy or something else? PLEASE...help

[justrobin1111]

Nine days ago I suddenly felt faint, then saw bright "kaleidoscopes" and had double vision that went away when covering one eye, I fell down every time I tried to stand, and eventually went to the ER.  my left pupil was bigger then my right, and the eye had rolled completely in towards my nose.  They thought I had a "TIA" and sent me to a neurologist who said I had "bilateral INO's"  

I had a normal MRI, CT Scan, neck ultrasound, and bloodwork.  I still  have the double vision unless my eye is patched, and saw an eye dr. and have lost almost all visual acuity in my left eye, and my right eye (uncovered one) has a dark film over it, or everything seems "tinted". Eye dr. said my eyes are undiseased and it could be a "cranial palsy" but my diabetes and hypertension have been well managed.  over the last week I have had constant headache, dizziness, nausea, and my vision seems worse.  My eyes see two different things.

Last night the headache turned to about an 8-9 on the pain scale, and I took 3 vicodin left from an old RX.  It gets worse/better but never goes away.  I called the neurologist and he left me a message that said he was scheduling a spinal tap - a month from now - and he didn't perscribe any pain meds or anti nausea medication.

I am terrified, to be honest. I feel like I'm going blind, no one has answered any questions, other than to say "it could go away in 3-6 months" in the meantime I'm taking care of an 8 month old by myself and I cant see to drive, read, or write.  I've fallen several times due to dizziness. Tonight I started having the "kaleidoscopes" in my eyes again, like a circle of green/purple knots turning. It's very strange.

Would the nerve palsy explain the sudden onset of symptoms? Will it go away suddenly too?  Could the (non contrast) MRI have missed something important?  I realize its not an exchange for actually going to the Dr, but please, any information or insight you might have could really help.

~RS

[justrobin1111]

I'm starting to get better! I was so afraid my eyesight wouldnt come back....It's not 100%, but its not so blurred I cant see anything.  Hubby says he thinks it was a TIA becaus the palsy wouldnt have given me some of the less health related concerns he has - Stuttering, balance, forgetting words, and crying easily.   I think those could also be caused by stress. I wonder if I should still go through with the lumbar puncture even if my eyes get better?

[justrobin1111]

Hello Dr. O,

Would a migraine last for over a week?  I had them when I was pregnant ten years ago, but didnt have visual symptoms other than photo sensitivity.

My eyes are better when I wake up, then slowly blur thoughout the day until I have to put on the patch to avoid doubling. Do you think the darkness in my right eye could be from wearing the patch?  its most pronounced at night, with more than 50% darker then my left, most affected eye.

They havent mentioned MS, maybe that is what he is ruling out with a LP.

My AIC six months ago was 5.8, compared to over ten a few years ago.  I am managing on metformin, and my sugars havent gone above 160 or below 70 for a year.

I have read about something called Optic Neurits, but Im not sure if the symptoms match.

I wont see my neurologist for a month, but I'm writing down symptoms to share.

Thanks so much for your answer, and I hope you have a wonderful day.

[Ray T Oyakawa, MD]

Bilateral internuclear ophthalmoplegia (Bilateral INOs) is caused by a brainstem problem.  There is a good chance it will get better.  You had an MRI and they did not mention MS.

This is probably related to your diabetes or hypertension.  You said your diabetes is well managed.  What is your glycosolated hemoglobin (HgA1c)?

It also sound like you have migraine and one of the complications of migraines is a stroke.

You should discuss this with your neurologist.

Dr. O.