QUESTION FOR DOUBLE VISION

[santana8]

Hi, it's santana. I was just thinking about something you said in one of the posts. You said

that you had a 6th crainial nerve palsy from a lesion on your brain stem. I was wondering if

you had any pain/stiffness in the back of your neck or in the sides? Also how did they test

you for the crainial nerve palsy? Alot of you visual symptoms  are very similar to some of mine.

I asked the neuro and opthalmologist about the possibility of a crainial nerve palsy and they only

looked at my eye movements. I definately felt some numbness in my forehead and scalp and my eyes

at the start were completely numb. I have experienced facial weakness and twitching too. Also a general

weakness down the right side of my entire body.Could you please tell me the test they did to find your

cranial nerve palsy and the brainstem lesion? I had one of the six MRI's that included the brain stem since

I was having symptoms in my neck. The neuro said that the only thing he saw there was some arthritic,

degenerative stuff. Any help on this would be appreciated.

Santana8

[santana8]

The neuro  the neuro-opthalmologist the virtigo rehab tech and the opthalmologist have all

checked my eye movements and say they are normal. I don't have a deviated eye. They

think that my trouble is from the visual field defect. My binocular vision is messed up. I

can't see  a whole of anything. Everything that I look at has a wedge shaped bottom right

corner missing off of it. I have double vision when I try to look  too far left or right or down

and in. It goes away when I cover one eye. It is not there at all unless I try to force my

eyes to look in the above directions together. They did not see any lesions on my brain

stem. THey did see some arthritis/ degenerative stuff there. My six MRI's  all show 6-8

lesions int the white matter. The neuro said right over the part where the central vision

center is. Also on the border of the corpus collosum. All MRI's remain unchanged without

enhancement. My spinal tap was negative with no O banding. All bloodwork normal. VEP

was abnormal, showing slowing in left eye. Neuro thinks it was ADEM, but can't

completely rule out MS until MRI shows change or have a new attack. It has already been

two years, who knows how long he will have to watch me. I did not get any steriods or any

meds to take down inflamation. Maybe that is why it is taking so long to recover. I would

say that I am 65-75 % recovered. I also developed dry eye, tear disfunction, and

blepharitis(inflamation of the eyelids) after the onset. I definately had numb eyes, scalp,

and forhead  which is almost completely recovered. Also twitches around eyes and on

face. I also have a weakness on right side of body, dyslexia, and concentration trouble.

The only eye pathology they can find is the surface symptoms I listed above and the visual

field defect. The rest is coming from my brain.

Santana8

[doublevision1]

Hi Santana

I did have stiffness in my neck at the height of my last flare which was last Sept-Oct.  I also had numbness on my scalp as well as the right side of my face and neck.  About a week or so after I was treated with Solu-Medrol, the stiffness and facial numbness subsided.

The lesion on my brain stem was detected with MRI w/ contrast.  Lesions in that area are often related to oculomotor dysfunction.  The 6th cranial nerve palsy was diagnosed upon examination of my eye movements.  As far as I know there is no other particular test for this condition.

6th cranial nerve palsy is also referred to as abducens palsy and lateral rectus palsy.

Here is some info I found on the topic:

http://www.merck.com/mmpe/sec16/ch219/ch219f.html

http://www.ncbi.nlm.nih.gov/pubmed/1532595?dopt=Abstract


From what I've read and been told, this problem most often will resolve itself in  3 - 6 months.  I am at the 6 month mark now and it has not resolved.  It has improved somewhat (my diopter measurements have gone from 40 dp to 15-20 dp) but I still have the double vision.  Early on, my ophthalmologist was much more optimistic than my neurologist that it would eventually resolve completely.  So I wait and wait and wait.  And hope.......


The past few days I have had a headache that will not go away.  It is not severe.  I recently started on Rebif and wonder if it might be a side effect of the drug.  However, the headache worsens upon reading, computer use, etc. perhaps it is related to eye strain and the problems with my eye muscles.  I have my monthly eye exam next week so I will be inquiring about this with my orthoptist.

When you asked your doctors about cranial nerve palsy, what were you told after they examined your eye movements?  Did they tell you it was not this?


db1