Doubled Vision

  I am a 44 yr.old female in good health.  I have a history of classic migranes (migraines).
  Two years ago I was in a car accident and had to have anterior cervical diskectomy.
  My trigger points have been inflamed and I have been recieving trigger point
  injections in my neck and shoulders.  I have also had doubled vision on and off.
  I had an MRI and everything was fine.  The double vision occurs usually after I do
  something  phyical.  Close a window and turn around instantly vision doubled,  Jerk a
  watering hose to get it off the corner of the sidewalk, vision doubled instantly.  It can
  last anywhere from 1 minute to 45 minutes.  When my vision starts to come back
  if I look straight ahead my vision is fine, if I look to the right my vision is fine,
  if I look to the left my vision is still doubled.  Sometimes but not always
  my tongue and mouth will get pins and needles on the right side.  My neurologist
  is now doing blood work for myasthenia gravis.  He said he doesn't think I have
  it, but just wants to be sure.  He felt I had complicated migranes (migraines).  I have never had
  a migrane (migraine) that I didn't know was coming.  This is making me crazy! I never know
  when it is going to happen.  If I'm driving I have to quickly pull off the
  road.  Also if I close one eye everything is OK.  It doesn't matter which eve
  I close.  If both are open my vision is doubled.  Any help would be greatly
  appreciated.
  Thank you,
  Barbara
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Dear Barbara,
What you are describing is a palsy of the abducens or sixth cranial nerve.  
The nerve projects to the lateral rectus muscle of the eye, causing the
eye to move laterally.  When injured or impaired, a patient will notice
double vision when looking laterally to the same side as the injured sixth
nerve.  In your instance, the double vision occurs when looking to the left,
so the injury is to the left sixth nerve.  This is most likely what is going
on.
The cause of your double vision is not clear.  It should not be due to your
history of migraines or the cervical fusion you had in the past.  Typical
causes of sixth nerve palsies include increased intracranial pressure for
various reasons, tumors, and diabetes for starters.
Let your neurologist know about the double vision you are experiencing, if
he doesn't know already.  The MRI will be helpful to be sure there is no
hydrocephalus or tumors causing your problems.  He should be able to give
you a more complete answer based on your particular situation.
Good luck.