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Anxiety, MS, or what? Very worried!!
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Anxiety, MS, or what? Very worried!!

Back in 2000, I suffered what I believed to be a anxiety attack, it left me with 3 months of nausea, because of not eating and no appetite I would assume that is why it lasted so long. Spring of 2001, still a little nauseaded, looking up nausea on the internet, MS came up as one of the reasons.  This is where my life turned upside down, my gram had MS, diagnosed at age 60, as you can see from my previous posts, I'm concerned.  I had the migraines before the anxiety, but when googling nausea and MS, came across the facial tingling (MS), shortly I developed the little bug crawling sensations, and I so have muscle twitches, seems worse when its cold.  I have never experienced weakness, numbness, bladder or bowel problems, I can tolerate heat.  I tried Prozac for about 3 years, it never took these feelings away, just recently started xanax, this helps a good bit, but not completely.  I have had these feelings for 6 years, thats why the doc ordered the brain MRI, he wasn't convinced that it was MS, just anxiety.  So you see this is the reason for all my questions.  Can anxiety really cause these weird feelings?  I live everyday worrying about MS.  After 6 years with no worsening of symptoms (sometimes better), do you think it could be safe to say its "psychological?" Never had the cervical MRI, just brain, neuro exam-normal, no problem there,bloodwork fine, was tested for Lyme (ELISA), my fear now after reading all these posts from Lyme patients is that maybe this could be my problem.  Thanks for your time, patience, and thoughts, they are greatly appreciated. 3 previous posts!!
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Avatar_n_tn
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
   From the symptoms and story you present this time and the previous 3 times, it is clear that you have a lot of anxiety.  Our job as neurologists is to identify possible organic disease that is surrounded by anxiety, or to demonstrate that no disease exists and that anxiety is the primary problem.  
   As I have shared in the past I do not think you have MS (multiple sclerosis), but I recommended completing your workup with a C-spine MRI and a lumbar puncture.  You should answer the questions and stop worrying about it.
  I also doubt that you have Lyme disease, from the symptoms that you have described.  A western blot and PCR for lyme, and a SPECT scan would complete your lyme workup.
  I have discussed the concepts of migraine headaches with you in the 3 previous posts (which you do have).  My advice remains the same, I would start a migraine preventative medication.  I would recommend that you find a neurologist that you can trust to put you mind at ease about these various conditions.
I hope this has been helpful.
30 Comments
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Avatar_f_tn
Did you know there is a rule of no more than 2 new questions posted in a six month period?  It's under the rule section.
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125112_tn?1217277462
I've seen the rules and see that a few are not enforced. Perhaps MedHelp, after setting the rules-didn't find a need to enforce them for whatever reason? Just a thought.
As for the limit being only 2 in 6 months...does seem "stiff."
Having said that, it's always good to leave room for others to post, agreed.
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125112_tn?1217277462
Jenny, have you given thought to posting to the Mental Health forum as well?
There is a form of anxiety called: Health anxiety. Those who suffer it and from I understand, tend to be compulsive as well.

As for muscle twitching/weakness (<---from muscles always being tense)-anxiety can cause this too. Magnesium is a thought as well.
http://dietary-supplements.info.nih.gov/factsheets/magnesium.asp

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125112_tn?1217277462
As well, b-12.

http://dietary-supplements.info.nih.gov/factsheets/vitaminb12.asp

Vitamin deficiencies (in general) can cause many problems. If you are not taking a good multi-vit w/minerals...I would suggest that you do so.

Google symptom and vitamin deficiency-should give you an idea of how much vitamins or the lack thereof can influence general health.

Good luck.
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Don't feel too bad, I posted a picture (recently) and then (after the fact)...read that I wasn't supposed to.
User agreements, admittedly, are something I have never paid close attention to. You are forgiven.;-D
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Hello,
sorry for your problems.  Sounds like you have stressed yourself into knots.  I know from experience that Stomach problems are often a symptom of anxiety.  But the muscle twitches can really be scary and annoying.  I have had twitches for almost a year now and it's driving me crazy too. I swore I have MS due to the twitching and tingling and "perceived" muscle weakness but, I've seen the neuro twice and he is now telling me that twitches are not usually a presenting symptom of MS and I should not worry.  He says many people suffer from similar twitches and tingling and they are just benign in nature and can also be a symptom of anxiety.  I do not think this is my problem, but it sounds pretty right on for yours.
I know its hard for even me to believe, but try to relax for a change and take some b-12 and magnesium.  Also, a big glass of wine makes me feel better sometimes,  it can really take the edge off the twitching.
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The MV that I take is called, "Time Release Complete One" Long Acting. I purchase it from Puritan's Pride when they offer the "buy 1 get 2 free" deals.

The reason I chose this vitamin (other than obvious) is due to "daily value". 100% RDA is minimal, in my opinion. YET the mega vitamins worry me. Particularly those with high A, D, & E in them. The reason being, is that our bodies store these vitamins up. One can overdose on vitamins.

Occasionally, I do supplement my MV when I think I need more of one, such as Magnesium (as of late). If I am sick with cold, I may boost my C and Zinc. Most often, I just take my good MV alone.
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Avatar_n_tn
I hear ya, I have been going through same stuff. All my tests clear, but not looked into the LYME thing. I was back east this year, prior to all of my sensations starting. Off and on my toes will tingle, bottoms of my feet, and the worst is the "burning" feeling I get on my back, legs etc. I have been told by two neuros is is stresss/ anxiety. It gets worse when I am relaxing, trying to sleep etc. I will even wake up with them.

How do you guys even post ?  I am on the west coast and have no clue when able to post.
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Texasbelly:

Dead on. The mind-body connection. I've always thought the mind was powerful but realized just how powerful it can be this last year. Unfortunately, not for the good. lol
If you have mental/emotional troubles, they can manifest into the body and yes, V/V. Or it can take a condition and make it that much worse.
Something that really needs to be reigned in because I for one do think they lead to physical symptoms if not medical problems later on.
I agree with the glass of wine. After my tonsils were out, they gave me ativan (first time I tried it). It helped. I summed it up to being equal to drinking a glass of wine or bottle of beer. When I get too wrapped up, I drink a dark beer or glass of red wine.


Hello,
sorry for your problems. Sounds like you have stressed yourself into knots. I know from experience that Stomach problems are often a symptom of anxiety. But the muscle twitches can really be scary and annoying. I have had twitches for almost a year now and it's driving me crazy too. I swore I have MS due to the twitching and tingling and "perceived" muscle weakness but, I've seen the neuro twice and he is now telling me that twitches are not usually a presenting symptom of MS and I should not worry. He says many people suffer from similar twitches and tingling and they are just benign in nature and can also be a symptom of anxiety. I do not think this is my problem, but it sounds pretty right on for yours.
I know its hard for even me to believe, but try to relax for a change and take some b-12 and magnesium. Also, a big glass of wine makes me feel better sometimes, it can really take the edge off the twitching.


fujiamy,

>How do you guys even post ? I am on the west coast and have no clue when able to post<

I'm up here in Alaska and found that getting in a question isn't easy. You will have to try different times. Around 11 am seemed to be the better time for me.  
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You bring up things that bring out things that I've been thinking about.

>As far as what you have...I would leave no stone unturned.<

I agree, that the responsible thing to do is to do your best at finding an answer. Sometimes, the answer is given to us and we are distrusting. Which isn't necessarily a bad thing, don't get me wrong.
After much time, agony and expense later...we go back to the answer and work on it to find, that it was right.
Wrong? No but well, something to think about.

>but I really feel that alot of people who post on this neurology forum do have lyme or some lyme like bacterial illess.<

Interesting and maybe many people do have lyme-that seems reasonable. In my early years, a tick was found in my back and my mother managed to take it out whole.

Anyway, my thoughts move elsewhere. Some of the things that I have thought about are environmental. One, vaccinations (mercury tooth fillings too): which contained Mercury. I think they've worked on better formulas since. Vaccinations have come under serious fire. If you are curious: http://www.909shot.com/

Other things and I may seem "radical" to even think about it (lol): radio and microwave waves?

Food: aside from eating wrong foods i.e. empty calories etc. what about preservatives? The diet of livestock and injectable hormones? The ground our produce are grown in and pesticides?
The air?

Combine these things with a sedentary lifestyle, other things we are putting into our bodies and leading a hurried lifestyle...I'd say that's a bad recipe in regards to health.

>I have never figured out why someone who has been sick for months and months with no answers would not at least try an antibiotic trial to see what happens, like tetracycline.<

I should think if he/she truly suspects so, would give it consideration. Yet a wise doctor is very careful about prescribing.

>Haven't any of you at least noticed that many of the people who post who are searching have so many of the same multisystem complaints.<

I have and find it interesting. I should think that doctors must stand up and take notice too. They must wonder.

Medicine is science. Some proven, some theory and so many unknowns. It's always evolving.  

>And I think that it is ridiculous to think that stress or depression can cause all these symptoms.<

I think it's good to question this. However, I honestly do think that both can cause numerous problems. Yet, I am still left wondering about the root cause of it as well. Variables, to be sure.

>I think doctors who are at a lost for what is wrong will blame it on stress or depression.<

I do think this happens often, too.

There are many outstanding doctors out there who are not only very educated but have excellent instincts and really listen to their patient. If the patient isn't asking questions, he/she is asking them.

There are many lousy docs out there as well. Some just are not equipped to deal with anything other than "ordinary."

We may never entertain the brightest but if we can at least find a good one, right in the middle.

It is IMPERATIVE that you find a good GP. One that you can trust, one who is interested, calm, thorough and unhurried.
One who isn't quick to run a billion test (and run up your bill) and throw out prescriptions one right after the other. Or one who is smug, disinterested and quick to wave you off.

I will tell you what a doctor told me recently while I was out of town. He said, "Kate, it's important for you to find a good doctor, one who will work with you." "There are many doctors out there will not/do not have you in their best interest...believe it or not."
I was blown away! And it is what I so desperately needed to hear.
I changed GPs (back at home) and I will say, first visit with him...I felt good leaving his office.
What was odd in talking to the doctor up North...is that he pulled me aside (to tell me this) while he was walking out from the cafeteria with coffee and I was going in to get the same.
The thing of it is, I didn't say much to him in the exam room but he must have read between the lines somewhere and instincts told him something about me.
Now that was one bright, instinctual and HONEST doc!  

It would be nice if this site offered an "open" discussion "forum" here, huh?

My personal thought is, in regards to the docs here-is that if they are genuinely reading these posts, they are probably one step ahead. A great deal of honesty shared amongst members here.
We learn and they must be learning too. I wouldn't be surprised if that isn't what, at least in part, inspired the creation of this site.

Regards,
~Kate
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Avatar_n_tn
I have read your posts many times reguarding lyme. I have not yet been checked for lyme but I will ask for the test on Monday.  I go in to the Neuro for some results of my EMG which I have a feeling will come back clean....

I am a cronic (chronic) sufferer with no diagnosis and have all of these symptoms (tingling, twitching, bigtime fatigue) but have not had any tick encounters for at least 3 years when I was in Penn. Could it have taken this long to surface?  I live in TX now and I have a new baby. 8 months.  Could he have it too?

Also, I had a HUGE lymp node removed from my cheak/ear 1 yr. ago, and other nodes have swollen intermittenly for no reason and have stayed that way.  Doc's say it's common and nothing to worry about, but I'm not sure.  

Also, recently I have TONS of floaters.  I think I read somewhere that floaters are common in lyme. Right? Neuro dismissed the symptom totally and said it was an ocular thing and I should see an Opthomologist. What ever.. Really TONS of floaters.

All of these things are just now occuring to me.  I'm not quite sure, but what if, I am tested and the test comes back negative for lyme. (I know the test is not accurate enough for a real diagnosis)  I don't think any Tx doctor is lyme literate enough to treat a negative lyme diagnosis.  what then?
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Avatar_f_tn
I didn't let you know about the rules to be nasty.  I just figured you didn't know. I hope you didn't take it the wrong way.  I just know it's very difficult to post a question and with only 2 questions per day, everyone deserves a chance.  It took me numerous tries when I posted.

In regards to your symptoms.  I completely know what you  are going through.  I have similar symptoms...numbness, tingling, twitching, pain.  I have had several episodes over the past year of whole left sided tingling, burning and numbness that lasts for weeks on end.  I have twitching all over, burning sensations all over, tingling all over. I'm a nervous wreck all the time, covinced I have MS.  I've had every MS test known to man..MRI's, evoked potentials, spinal tap, EMG's etc...I've seen 4 neuro's including an MS specialist.  All said no MS but none could say what it was.  I think anxiety is way over rated as a cause of our symptoms.  I think it's the symptoms that cause the anxiety..not knowing what it is, what it will do etc...It has put my life at a standstill.  I can't plan anything.  I live from day to day with no answers.
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Avatar_n_tn
I guess it's just good to know that there are others out there who twitch tingle and post. Thanks
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Avatar_f_tn
Did the prozac help with the worry?  paxil can be very helpful for obsessive thoughts.

Let me play devil's avocate for a minute.  Just say you have MS.  What would that change? What I'm trying to say is you are already living your life at half strength due to the worry.  In the end we will all die and we will all get a disease/illness one day.  In the meantime while we are symptom free, well they are only mild (unless they are debilitating, sorry if yours are)we should enjoy life to the maximum.  I am very bad at taking this advice myself.  

I might be completely off track if MS is treatable if it is caught early but I'm not sure that it is one of those things that time is of the essence.

just trying a different thought approach as I assume doctors have already cleared you of the MS diagnosis.  

Good luck
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Avatar_n_tn
Hi Jenney,

I guess what i would really like to say is I agree with what Kate is saying ( borninquisitive).  I resent when a doctor tells me this is all due to anxiety. How could one not be upset or anxious when there bodys are so sick.  I did go to a therapists at the advise of my Neuroligist....this is a quote from what she told me.  " You have APPROPRIATE anxiety for you situation" Believe me I went back and told my Neuroligist who then just snubed me.

Hi Kate,

You bring up excellent points.The sad truth is that there are more doctors that dont truly understand or want to help.  Finding the one, which i have, is crusial in getting better.

My story is very similar.  All the same symptoms, tingling, numbness, crushing fatigue, muscle twitchin and jerking, weak lega.  I have had two Neuroligists rule out MS.  Afetr two years of being convinced I had MS I now have a diagnosis of Lyme disease and am in treatment.  I know that I have lyme disease.  Not knowing is the worst part.

At any rate feel free to email me at home if you guys have any quetions or concerns.

Good Luck to all of us who so desperately need to get better.

***@****

Lesley
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Avatar_n_tn
I see a lot on the forums about "trial antibiotics".  What is that?  I'm allergic to so many antibiotics, though I can take Cipro.  Not sure about Tetracycline.  Do you just ask your doctor for a "trial" and he just gives to you?  Isn't it the same as a regular prescription of antibiotics?  

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Avatar_n_tn
Hi again,

I agree with the trial, I'm a vet and we do this a lot in our everyday practice. Sometimes the animal completely recovers and we never learned what was causing the animal to so sick.

So why not doing this with humans? As long as I'm not given something that can kill me, why not??

Are you still in treatment? Have you ever had any positive test for Lyme (Igenex, etc)?

All the best,
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Avatar_n_tn
I can tell you from first hand experience that Anxiety CAN manifest itself into many types of body ailments and horrible feelings.  Everyone is different and their bodies show the anxiety in different ways.

I would have a doc treat your Anxiety with serious meds, then see how you felt.

I went through this just a few short months ago.  The Zyprexa worked very quickly and as the anxiety went away, my feelings of poor health did too.
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Avatar_f_tn
Hikerrunner, your above post was very good.  I didn't read the post about people being hypochondriacs though.  After what I have been through, I have no faith in doctors.  They misdiagnosed my neuro problem as being cervical myelopathy from a herniated disk.  As a result, I had an unnecessary surgery which greatly worsened my condition.  I was also diagnosed with fibromyalgia which I don't believe in anyway.  I believe  chronic pain, fatigue conditions exist but they have to be caused by "something".  Two doctors diagnosed me with fibro (neuro, rheumy)neither checked me for the tender points which are the diagnostic criteria for fibro(11 of the 18 must be present).  There is no way I can trust doctors after this.  In regards to lyme, I had 3 bullseyes 13 years ago followed by a condition just like I have now.  I did improve on antibiotics.  I have never tested positive for lyme.  I took antibiotics again this time but had to travel out of state to see a lyme specialist as the docs around here won't treat without a positive test.  I don't know if I have lyme or not.  I'm skeptical probably because I am also in the healthcare field and am used to seeing abnormal test results correlating with diseases.  I think it's definitely worth a trial of antibiotics.
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Hi Patsy,

Just wanted to say....I hope you are taking your advise!!!!!!!" LOL
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Patsy
The 'hypocondriacs' post is below under 'Muscle aches, pain, joint pain' question. Do read it - its grown into a very interesting debate.

I don't want to make Jenny feel bad, as I know shes having a hard time, and we have talked before, but I did feel quite upset when I saw she had another question posted. I have been trying to post for nearly a year now. People say you need to post around 10am Cleveland time. I live in NZ - thats around 4-5am here and I am ill - I can't stay up trying. They say the oppertunity is set at different times each day - to allow for those of us in different time zones to get a chance, but nine times out of ten, when I check in the morning, there are 2 new questions there. I have got a great deal out of this site, but I would love the oppertunity to ask my own unique question. I know that if Jenny had not posted, someone else would have.

I have read all of Jennys posts, here and on the undiagnosed forum and I'm sorry to say this, but I do believe the problem is mostly anxiety based.
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Avatar_n_tn
Your six years must've been very difficult, but I'm going to have to agree with zzzzzzzzzz.  You've had a lot of tests done, and all have come back negative.  The chances of you having MS are vanishingly small; sure, it's possible the tests missed something serious, but when the odds become one in a million, it's time to resort to the simplest theory: it's psychological.

All of your symptoms can definitely be caused by anxiety.  The brain is incredibly powerful.  I've had some frightening symptoms myself (constant nausea and dizziness, strange sensations in my head, etc.).  I also understand the doubt and suspicion you're feeling; I found many reasons to doubt the diagnoses of my doctors, the results of my tests, often with increasingly sophisticated lines of reasoning.  But after a long and hard examination of myself I concluded that I was a hypochondriac, that I had been a hypochondriac for the last few years of my life, that the symptoms could largely be explained by anxiety, that I was probably physically healthy.

Once I truly began to accept that my symptoms were largely psychological and likely harmless, they went away.  I've been feeling great for about three weeks.  Sometimes I sink back into worrying, but for the most part I'm sleeping well, eating well, and enjoying life.
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I don't know how to start a new post, so I'm going to ask a question on this one.  I've been reading this board for more than a month now and I think it's unlikely I will ever get to ask a question of the doctor, especially since others have been trying for a year to post and haven't gotten through (though I plan to keep trying).

Has anybody on this board been diagnosed with GASTROPARESIS  (delayed stomach emptying)--especially severe gastroparesis-- (picked up on endoscopy and/or gastric emptying scan)?  It's usually caused by damage to the vagus nerve.  If so, what diseases (neuro or otherwise) have you been dxd with?  I mean, is there anyone on this board who has gastroparesis with MS, or gastroparesis with other autonomic neuropathy or gastroparesis with a connective tissue disease (lupus, scleroderma, vasculitis, etc.)?  I know it's associated with diabetic neuropathy quite often, but I'm not diabetic and have had other ongoing neurological symptoms (past Horner's syndrome (first symptom I had), tingling in left hand/foot, weakness in left leg/arm, blurred vision, mouth droop, difficulty swallowing, ongoing slowed breathing/chest pain/weakness after a viral infection), eye inflammation, etc., all triggered off or exacerbated by infections, heat and, strangely enough, ovulation.  

I was just dxd with gastroparesis two months ago and have read hundreds of articles on it since, and all of them say pretty much the same thing (main causes are diabetic neuropathy, damage to vagus nerve during gastric surgery, Parkinson's and thyroid disease, but also that it is associated with different neurologic diseases (including MS) and connective tissue disease).

I'd appreciate any anecdotal evidence of its being associated with other neuropathy/neurologic conditions.  Thanks in advance.
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Avatar_n_tn
Thanks for your response, JennyWren.  There might be a connection between the migraines that you have and ovulation--I don't have migraines and I really don't know much about them--but I'm sure hormones could very well play a role.  

But my understanding is that gastroparesis is a permanent condition that almost always is caused by damage to the vagus nerve (unless it is due to drugs that slow down stomach emptying--then it could be something temporary).   Also, gastroparesis is diagnosed primarily with a gastric emptying study/nuclear medicine, though if it is severe it can be picked up on EGD as well--which mine was.  I have never read about any connection between migraines and GP, and I do not think my symptoms are due to even painless migraines, but thanks for the response all the same.
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Avatar_n_tn
If you can take cipro, and unfortunately you have to resort to it many times, or just once for a long time, or a high dose, you might end up with extremely debilitating injuries, that sometimes are permanent. The new package insert for cipro states that irreversible neurological damage can occur, and if fact it does.

Many people are diagnosed with lyme, fibromyalgia and some inmunological and neurodegenerative diseases, when in fact they are suffering from the toxic effects of cipro and levaquin.

You might also consider the possibility of retracing back your story of cipro treatments, and your current symptoms to rule out first of all that they are not the emerging tip of the damages caused by cipro.

If you need some quick information to have a look at, you may visit these sites:

www.fqresearch.org
www.fluoroquinolones.org

or do a search on your own.

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Avatar_n_tn
Sorry to spoil your day - it truely wasn't my intention. I just don't know what alse to say to you jenny - except that which i said - you need to get a grip on yourself - for the sake of your family as well as you. You are obsessed, and it must be distroying your life. You have been told what you need to do by the Neuro - so go do it - find out once and for all. Sweetie, I am sorry - you sound like a really nice girl, whos hurting alot, but I doubt anyone can help you here - more than they already have. You need to talk to someone face to face and you need to get those tests done.
There are so many people who cannot manage to get their questions posted - maybe they just don't have the time to be sitting there trying all the time - I know I don't. I'm not angry at you that you managed to do it 4 times - just concerned that you're putting so much time into it when you are a mother! and you need to be taking care of yourself. It surely cannot be doing your neck any good either. I truely am concerned for you.
No I don't have a relative with MS - if I did I would have a 10% more chance of having it than I do now, but i do understand the fear of it. Do you remember that I am still under investigation for it? and the reason for that is because I have alot of the symptoms - at the moment I can't work because it causes my eyes and arms to spasm & the pain is so bad I want to cry. My work was what kept me happy in spite of all this. At times I have not been able to go to sleep because when I close my eyes, they go crosseyed and the pain is so intense. So you see, I do know what its like - very very much.
And sleep I must, so I wish you well Jenny - hope you understand that. Good luck
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Avatar_n_tn
Just one more thought - in all your research into MS, had it occurred to you that your Grandmother was possibly mis-diagnosed? The LP results would not have been enough to meet the criteria without positive MRI these days. Positive LP can mean a number of things besides MS. Alot of people have been  wrongly diagnosed in the past.
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Avatar_f_tn
Jenny,

5% of the population diagnosed with MS have no lesions in the brain or c-spine.

It wasn't until 1990 that the neurological community started using MRI's for a diagnostic tool for MS.

It's a combination of test that are used.Mri of brain,c-spine,some neuro's do thorasic.Lumbar puncture checking for o-bands,iGg synthesis,protein,and myelin basic protein.
Eye exams,reflexs hyper is the norm,but they can be hypo depending on lesion sites or progression.Babsinki sign,up going toes or down going.Romberg,test balance.EMG/NCS checks for conduction blocking.Evoked potentals.Great little test.Picks up on lesions not depicted on MRI's.Visual,somatosensory(spinal tract)Baer,test ears and balance.

I went 2 years with no DX,very frightening symptoms,finally a neuro at the cleveland clinic done a series of evoked potentals.My Lp had extreme high levels of myelin basic protein.My body was attacking itself.Then come the DX.

A persons body has a natural process to heal itself,if demylination is in the early stages it can remyelinate without any damage left.Its not until the myelin has broken down and no longer able to heal,thats when lesions appear.

Anxiety is a symptom of MS,but also of many other disorders.Migraines and MS can be associated with each other.

Jenny,you may just need time to sit back and take a break from DRs.Symptoms are frustrating but not life threatening.

I was Dx with MS without MRI lesions.I do have one small one now in occipital region along with occipital atrophy.Pronounced for age(40).I am in that 5%.I have bilateral absent reflex's,they went from hyper to gone.I have numbness and tingling.Optical neuritis.Right sided weakness.

Hang in there,keep positive thoughts.Not knowing what causes your symptoms is extremely an emotional roller coaster.I know I road it for 2 years.
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Avatar_n_tn
Hi young at heart,

I'm sorry for your problems, but happy you get it dx. Not knowing what is going on with you can be the worse thing in one's life.

I wanted to know, you mentioned you had/have optic neuritis. Is this something that you can notice you are having or can you have an optic neuritis without knowing?

Thanks,

rcs2
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