Abnormal VEP doesn't prove optic nerve damage

[tasha822]

I may start to rant a bit so please bear with me. Today I went to the eye doctor who diagnosed ON in my left eye last year. I went back today for more vision problems such as blurry and double vision along with a lot of pressure behind my eyes. WELL this doc told me in the same 10 min conversation that he was the first one to diagnose my ON and then went on to say at the end of conversation that I have never had it!!! When I explained to him that my neuro did a VEP and it came back showing severe damage, he said "that test is good for nothing, It proves nothing" Am I crazy? I and my husband were so befuddled that I got up an walked out!! Could someone please explain this to me? Does a VEP show nerve damage or not? Does it prove ON or not?Sorry this is so long but, I'm feeling a little CRAZY right now!

[COBOB]

There are other people here that have worked as allied health care professionals.  I spent 12 years in Biomedical Engineering, so I might know more about imaging and lab technology than most doctors.  I worked on some of the first clinical MRIs (NIH Bethesda) in the US (about 25 years ago)  and was active in the Picture Archive and Communications (PACs) technology up until about 8 years ago.  I have a bit of a background in anatomy and physiology.  I still have friends that are neuro-radiologists and interventional radiologists.

Some of my information may be dated, but I usually try to check it before I post it.

Bob  
(past Biomedical Engineering Tech/past First Class Navy Corpsman/Enlisted Surface Warfare Specialist, current Senior Systems Engineering Professional and Senior IT Infrastructure Architect, current Consumer at Rocky Mountain MS Center)

[Lulu54]

Hi tasha, glad to read you are making progress.  ON  doesn't always mean that you will move on to having MS, but it does increase the odds that you will progress that way.   Hopefully the optha gets you into the neuro sooner than you would on your own.  The waiting is one of the hardest parts.

Kirsten/Prince.  Hi.  I thought we should clarify that there is only one doctor here and that is Quix - she is a pediatrician, retired because of her MS.  She has been struggling with her own health and we don't see her here as much as we would like.  We do have several nurses and a PT that stop through and answer questions.  Other than these few, the rest of us are just medical consumers like you, learning about this as best we can.  The expert forum has doctors to ask questions to but they charge $20.  You would have to decide if it's worth the $$.  

Lulu

[Sidesteps]

He sounds like he's suspcious and I would agree with him. You can have ON without MS (just one episode/one area) though but you need to have a good Neuro monitoring you for sure!!!

Hang in there - I've been running around a mulberry bush for a year now. I hope to have answers when I see the Neuro-Ophth SOON....I'm still waiting for them to call. Hmph.

[tasha822]

So today I had another appt. with a retina specialist and the results are 20/40 right eye and 20/50 left eye ( the one with ON). He saw a silver looking spot on my left optic nerve and said that all my new symptoms are most likely ms related and wanted to know when my next appt. was with my neuro. I told him I have been trying to get in to see him for the past 4 weeks. So he told me he would have his office call to make the appt. cause he thinks I need a new mri. I think this is good news what do any of you think? I'm not sure...

[Sidesteps]

Yup, seek a new Neuro.  

[COBOB]

If there is no comment about the waveform, it is most likely normal.  A P100 conduction velocity of 122.25 mS is abnormal and is an indication of demyelination of the optic nerve.  If you doctor is not concerned about this, it is time to find a new neurologist/neuro-ophthalmologist.  

Not sure what kind of "eye doctor" you are seeing, but 122.25 mS is not normal based on the published literature.

"Maximum value for P100 is 115 milliseconds (ms) in patients younger than 60 years; it rises to 120 ms thereafter in females and 125 ms in males."

http://emedicine.medscape.com/article/1137451-overview#aw2aab6b3

Bob

[meneither123]

I got no VEP results from the lab or papers to look at. So I have no idea???? He said there was a lag but what's that? I hate being treated like an idiot (although I'm raving like a lunatic). Straight answers, no simpering, no blowing me off, no handing out Prednisone (which does dry up my sinuses, ears, and lungs so not really griping about that). I just want straight answers. Period. I don't want to be blind. I could never tolerate that. ECT took out my right brain self so blind is not acceptable. Just saying.
I'm glad I'm on here. I've blown a lot of steam off and won't be looking at neuro-opth like I'm going to jump up and beat him the first simpering he does. I will however try to remember everything I want to tell him that is very possible for vision loss so..........thank  y'all!