Diplopia for 10 months

I ahve had diplopia off and on for 10 months.  After first MRI, they mentioned possible MS, neuro said migraines (I never had headaches!). second opinion said now way on mS. went to neuroopthalmologist who said wear prisms and sent me for 2nd MRI (3 months post 1st).  Today she said 4th cranial nerve palsy and saw changes in my medula and pons within 3 months of the first MRI.  Now off to another neurologist on Friday.

Why is this so difficult to diagnose?  I am an otherwise healthy 38 Yr. female.  All of my other tests are normal.  could this slowly progress into something more?

[slightlybroken]

Well, this is just my opinion..but I believe it's so difficult to DX because some neuros tend to only think inside a tiny box per se. They believe that if you've had attacks...you should have evidence of those attacks right from the start. I don't believe this. Plus the neuros tend to rely on the MRI machines..alot...to show the entire picture. It's a proven fact, that MRI machines don't show every lesion. Don't get me wrong. If you have MS, you WILL eventually, develop damage..lesions. That's what the disease does, but there has to be a starting point for all diseases, if that makes any since.

MS is still a "clinically DX disease"..meaning, a good history of symptoms, a good neuro exam to find clinical lesions (abnormalities on exam), and trying to find anything else that might cause your symptoms (MS mimics/blood panels).

I have read..that sometimes when you have an attack, that the damage isn't seen on MRI until 3 months after...which could be what happened in your case. I would definitely..find a good neuro. Especially since there is changes on MRI now.

Good Luck Fri
Take Care

[doni54]

Slightlybroken has answered your question well and told you the process of getting a dx.  

It is just a daunting process when it comes to MS, and yes, many times it depends on whether you have a good neuro or not.  Some neuro's go strickly by the McDonald Criteria, and won't budge an inch to give a dx of MS.

We have some really great articles in our health pages.  They will give you an idea of what is looked for on the MRIs and what the neuro has to see in order to dx MS.  Just click on the health page icon at the top right of the page.

Some here have been dx with no lesions or maybe one or two showing on MRI, they had great neuros who thought out of the box.  They listened to their patients and didn't give up until a dx was found.

Have you had any other symptoms? I know you said you were healthy other than the double vision, just wondering.  I know many here have the same problem as you, some are dx and some aren't.

I hope your new neuro on Friday can help you find your dx.  You are always welcome here and we will try to find answers to your questions when we can.  I think you will love all the people here, they are the greatest.

Take care,
doni