Ocular/complex migraines or early MS?

[te6698]

I'm a 29 year-old female who began having loss of peripheral vision back in July. I had 3-4 20 minute episodes of losing peripheral vision in one eye at a time (was like blackness came from the side of my vision) within a 2 week period.Symptoms then changed a bit to what neuro says are ocular migraines - reading about ocular migraines they do seem to fit except they can occur in both eyes at the same time, not just one which seems to be the typical symptom.Normal MRI of brain and C-spine and an MRA of head/neck which questioned stenosis in left internal and external carotid arteries.Follow up carotid ultrasound was negative.Bloodwork showed elevated CRP level(usually indicative of auto-immune disease, but neg for lyme, RA).Hx of early heart disease in family.Personal hx of high cholesterol, triglycerides and recently high BP.Neuro put me on Verapamil to see if it helped the ocular "episodes" as well as to see if it helps my regular migraine headaches.Episodes occurred again for roughly 4 weeks from August -September and other syptoms started occuring independent of the migraines or ocular migraines such as feeling of heaviness and/or weakness and tightness in arms.All symptoms resolved in late September until mid January. Now I am again having ocular disturbances nearly daily, my left eye twitches all the time, arm aches/weakness and now occasional leg weakness for past 3 weeks - do these sound like MS symptoms?What about the normal MRI? Also worried about possible carotid issue given abnormal MRA, but normal ultrasound?

[Annie62]

Regarding the Lyme test, according to others on this board who have been the Lyme route, the ELISA blood test that doctors routinely order only tests for one/a few strains (?) of Lyme and apparently there are many differents strains of the infection, so it is apparently not inclusive.  They seem to recommend a lab in CA called Igenix (sp?).  Don't know how you get your blood their, but you could contact them if you even think you might have Lyme.  

[te6698]

The eye twitching is not from stress, it actually starts occurring 2-3 days before any of the ocular migraines start, it's almost like a warning sign that they are going to start up again. Alos, no one told me a high CRP level definitely means auto-immune disease, they just said it could be indicative of it and given my other symptoms it was the first thing they wanted to rule out. Also, I am still concerned about the conflicting MRA and ultrasound results but the neuro says the ultrasound is more reliable. I'm not too fond of the neuro anyway, I feel like he doesn't listen.

I neglected to mention in my first post that I was diagnosed with an Arnold Chiari malformation at age 15. The neuro is aware of this but doesn't seem to think it has anything to do with what's going on now. I honestly don't know too much about what symptoms are associated with that condition, I know when I was diagnosed I was having bad head pain in the back of my head at the base of my skull which got better with cortisone injections.

Overall it's just frustrating to have these symptoms reoccur and not really know why. They don't occur with the classic migraines or with the ocular migraines, they occur independent of them. BTW, as far as Lyme disease goes, if the blood test is unreliable how else would you know if you have it? Is there any other test for it?

[Ravyn007]

I don't mean to be rude but who told you that elevated CRP level is associated with auto-immune diseases? This isn't necessarily the case. Higher than normal C-Reactive Protein level could indicate bacterial infection or inflammation. CRP levels do not always change with viral exposure and really shouldn't be used for definitively diagnosing someone with an auto-immune disease. You could have elevated CRP levels from a myriad of conditions, some minor and some more serious.  

You should also know that just because your lyme test came back negative doesn't mean you don't have Lyme's disease. I've known people to have upwards of ten Lyme tests, all negative, who were later diagnosed with Lyme's disease. The test is just not that accurate. Although there is debate on this subject most medical professionals will tell you how inaccurate the test for Lyme's disease is.

That's not to say that you have Lyme's disease but I wouldn't necessarily out rule it just because of a neg. test result.

If your MRI came back clear than it is not likely that you have MS. I would say that you need more testing since your MRA came back with abnormalities. I can't comment on whether the abnormality is from carotid artery disease. You'd need further testing for this.

The eye twitching is probably blepharospasm, which is a benign condition usually caused by caffeine, stress and lack of sleep. Your probably stressing so much that it is causing your eye twitch. I wouldn't worry too much about it. The vision problems are unrelated to the twitching and again could be caused by a huge variety of conditions including migraines. I'm not a doctor but it does sound like it could be a migraine.