Not sure what's going on............

[a little scared]

I am a little scared about what is happening to me.  I had a bout of ON about 6 months ago - treated with intervn. steriod. At the time of my ON I had some tingling on my right side that lasted for maybe a day. Since my treatment I had what appeared to be a relapse about 2 months later - not total loss of central vision as the I did the first time but a decrease as shown by visual field testing.  My balance is slightly off and has been since initial ON and I have a tremor which I have always had(and is something many family members have)that has also become more active since ON.  I had a clear MRI and have been told this is a one off ON - don't worry, etc. I am worried and although I feel very well now and am trying to follow a very healthy life style I can't help thinking about MS....What is your advise to your patients with these symptoms? Thank you in advance.

[CCF Neuro[P] MD, RPS]

Dear "A little scared":

The clear MRI is a good sign.  Optic neuritis is the presenting sign in about 30-40% of MS patients, and patients with ON go on to have MS in about 50-60% of the time (approximate).  So as you can see, not every one with MS has ON, nor do all patients with ON go on to have MS.  I would advise you to choose you neurologist carefully and say in touch with him/her.  If you start having symptoms then you need to keep you neurologist updated.  I truely hope you are one of those with ON and do not develop MS.

Sincerely,

CCF Neuro MD

[a little scared]

........not sure if this is important - I am female in my 30s

[pacca1000]

Wish I new what "ON" is.  I have similar symptoms, except for the temporary blindness.  If anyone knows, could you please post the name of this disease/illness.  Thanks.

[a little scared]

ON - is Optic Neuritis - it is an inflamation (inflammation) of the optic nerve. Frequently associated with MS, however not always.

[Answer to ON question]

Optic Neuritis - inflamation (inflammation) of the optic nerve, stong association with MS.The optic nerve is second of twelve cranial nerves (only surpassed by the olfactory nerve- the sense of smell). It is responsible for carrying back the images "seen" by the retina, back to the brain where the images                  can be "perceived". Any damage to the optic nerve can be disastrous with respect to vision.
                 In optic neuritis, the optic nerve becomes inflamed. The degree to which it becomes inflamed or swollen determines the effect on vision. In some cases, it may only affect the peripheral vision or affect the central vision to only a slight degree. There may only be a difference in color or      contrast noted. Though, in some cases, patients may be left legally blind with a central dark spot in their vision. The symptoms besides the visual changes, can include eye pain or flashes of light with movement.

                  Optic neuritis can occur at any age, though the average age is in young adults. Children can be affected, and it can occur in both eyes whereas in adults it is usually in one eye only. Finally, women are more likely than men to contract the disease.

                  The classic hallmark of optic neuritis is recovery. After a period of weeks, the vision should recover. And in about three-quarters of people, the vision will recover back to normal. In others, the vision will recover to nearly the same level. However, there may be slight differences in the         vision with respect to color or contrast discrimination. Twenty percent of patients will suffer another attack in their lifetimes.

                  The fear with optic neuritis is its association with multiple sclerosis.
It's impossible to tell which patients will develop MS, and which will not. Any concurrent systemic symptoms (weakness, tingling....), can help. And, an MRI scan can show characteristic brain lesions associated  with MS. In any case, patients with optic neuritis should have an evaluation by a neurologist.

                  The treatment for optic neuritis is controversial. Steroids have not shown to improve the final vision, but intravenous steroids do speed the            recovery. However, oral steroids alone may increase the risks of recurrent attacks. Interestingly though, intravenous steroids may decrease the risk of developing MS for two years. The treatment is tailored individually, depending on the amount of vision loss and systemic findings.