Optic Neuritis

[Shawnj]

I'm curious, I've read that Optic Neuritis is a sudden loss of vision (partial or complete), or sudden blurred or "foggy" vision, and pain on movement of the affected eye.  I did not have any of that, what I had was diplopia (double vision) in my left eye and Nystagmus of my left eye.  After IV steroid, it went away after 4 days.  I've also read that Optic Neuritis is a symptom of MS.  I don't believe I had Optic Neuritis because I did not have those symptoms.  Am I wrong?

However, I've been told by my neurologist that I have the about an 80 percent (more like 90 percent) chance of getting MS because he found obligoclonal bands in my CSF and had a CIS.  

[Quixotic1]

Hi, Shawn, it's really good to see you helping on the forum so much.  You're in a difficult transition period.  To answer your questions:

The symptoms you had were not those of Optic Neuritis.  You are correct.  The diplopia or double vision is caused by a malfunction (usually a weakness, but may be a spasm) of one of the muscles that moves the eye around.  Three different cranial nerves (#'s III, IV, & VI) allow the eyes to move in their full ranges.  When one of those 3 nerves to one (or both) sides can't do it's job, the eyes can't move to focus on exactly the same spot.  So each eye gets a slightly different view than the other.  This is the cause of double vision.  Sudden dysfunction in one or more of the cranial nerves, especially associated with other neurological symptoms, should raise a doctor's suspicion of MS.

The nystagmus is a jerking back and forth ( It has a slow pull to one direction and a short jerk back).  This indicates (in the context of MS) a problem (lesion) in the brainstem where a huge part of the spatial orientation, directional and gravitational information is processed.  In other cases a problem with the middle ear can also cause nystagmus.  Or spinning around in circles and then stopping will normally give almost everyone a short bit of nystagmus.

From what I have read on CIS, combining your neurologic symptoms with the lesion on the brain MRI  PLUS oligoclonal bands puts you nearer the 90% (if not higher) category.  Your doc was right on!  Actually, my interpretation of this is that you DO have MS, but the second attack has not yet occurred, so the only "hold-out" is the actual diagnosis of Clinically Definite MS.  

Optic Neuritis can be seen outside MS.  But it is so characteristic of the disease that someone with a completely isolated bout of ON, without any other symptoms and a clear MRI, still has a 33% chance of showing full blown MS with 2 and 1/2 years and over a 40% chance of developing MS in the next decade.

Does this answer things?  Quix