visual evoked potential

[msleigh]

Hello all
I haven't checked in since my neuro said I didn't need meds. I am kinda confused. I did have a VEP after that. His nurse called me and said it was normal.  Then I got the results in  the mail and said it was abnormal. I'm not sure what to think now were my other test not normal also. P100 latency on left side 108.8 and right 105.35 left to right difference of 3.45  evidence of dysfunction in anterior visual pathways bilaterally as seen in demyelinating conditions, clinical correlation recommended.  What does anyone thing it would sure help me  thanks Leigh

[msleigh]

Well starting back in 2006
2006 winter I think/auras and pain behind eyes and upper teeth hurting almost every day lasted 4-5 hours/ felt very fatiged just didn't want to anything/double vision lasted about half hour several times during month /on and off warming and numbness feeling in feet
went to eye dr/ said no vision problems swelling of blood vessels in back of eye no tears and ENT said my sinuses were fine could be related to neck /my dr said we would do a mri of head and send to neuro but it all went away so we didn't do it/ this lasted about a month or so
2007 October blurred vision and dizzyness/whirling felt like I was going to fall over was several times thru out the day lasted until March. I still get dizzy and blurred vision just not as bad. Muscle spasms and numbness is still is on and off and is still going on. The arm going dead was in this time frame also lasted about a half hour.Twitching and muscle contractions are not as bad as they were from October to march. Alot in feet, pins poking, back then toes would contract thru out the day. I had alot of mind confusion then, very emotional,mind stuff is still going on, just not as bad, good days and bad days. Sometimes people would talk to me and I just couldn't concentrate on anything they said . Bladder urgency is still going on. Alot of little things also.  Is this more what your asking for. There are probable other things just didn't think about it at the time. Thank you for all your help Leigh

[Quixotic1]

I really need you to put your symptoms into a Timeline where you go back and tell when it all started and with what symptoms.  Then, as briefly as possible how low those symptoms lasted and whether any continued.  Continue to mention when different symptoms began or worsened.  Mention any times when you were mostly alright.

A list of symptoms, however scary it might be all put together, does not show the pattern of illness as you had to live through it.

The pattern is often the key to a diagnosis.

If you already have a diagnosis of MS, and you probably should, then you need a new neurologist, preferably an MS speicalist.  Please read the answer I just gave to "Sunshine" about needing a new specialist and how to find one.  Also go to the Health Pages and read "Why an MS Specialist."  It gives other ways of finding a good one.

Maybe your current neuro is lazy or afraid to make the diagnosis becasue he hasn't stayed up-to-date on treating it.  Who knows!?

You've got to be proactive here!

Quix

[msleigh]

I thought I would write what the mri results were: Many focal lesions are present in the periventricular white matter and centrum semivale.(where is that?) Many lesions are peicallosal. The lesions vary in size from 2mm to the largest in the right posterior frontal and anterior parietal region measuring 9 mm in greastest diameter. The largest lesions are on the right as described. There are at least 20 lesions. These lesions do not enhance with gladolinium. No lesions in the brain stem. Small amount of increased signal is present in the deep white matter of the occipital lobes. Findings are consistent with an extensive demyelinating process. This is most likely multiple sclerosis. Other etiologies include vasculitis, complicating migraines. Thanks Leigh

[msleigh]

I also have bladder issues urgency. I feel daily it is a struggle and don't know where I the next thing is going to happen with my health. sight, memory, musles spasms, neck etc. Thanks for the clarification on the vep. I did put in a request for all my records and test results. I,m not to sure if I should be waiting for something over the top serious to happen like not being able to walk or not see before I do something.  I look forward to your answer    thanks again for you help       Leigh

[msleigh]

I'm back,
To answer your question about lesions they are from 2mm to 9mm. I have had dizziness, whirling and unsteady, auras and double vision with pain behind my eyes, numbness in fingers, toes, arm was completely dead, leg pain and numbness. Alot of muscle spasms in hip and all over some like vibrating contractions . I also get twichy and shakey.  A  feeling like a big pin poking in my feet, a warming sensation also in feet and legs. Ears ringing and pressure. I also can't remember things,can't spell simple words and they don't look right when I do,not being able to say words or my mind goes blank, names of people I've known forever. Lack of concentration. I am very tired and wiped out just fall asleep and my whole self fells exhausted and whole body just hurting.
This is over a span of two years.  

[Quixotic1]

Hi, Leigh.  The test report sounds wrong.  Even though the P100 Latency is said to be normal at 100ms, in actuality there is a variation as you average all normal people.  For normal people younger than 60 years old, the P100 Latency is considered still in the mormal range up to 115ms.  The upper acceptable limit rises to about 120ms after age 60.  Also each lab should have established it's own normal values.  The 115 is the general range looking at many good qualified labs.

So a neurologist would see the values of 108 and 105 as "in normal range."

But, there is a slight difference between the two sides.  In my reading, this is not unusual in normal subjects.  My question is whether 3.4+ms is within normal limits for a difference between the sides.  I haven't seen anything that addressed a disparity this small.  But, both eyes were were in the normal range.  Each one alone would be called normal.  And the body is not always perfectly bilateral.

You need to write a letter (send or fax) or email the neurologist asking about the disparity between the two sides.  I suspect he will say it is not enough to call abnormal.  It is not uncommon for a lab value to be report as abnormal, but for the physician to know that the values are okay or can't be interpreted.  This happened to me all the time.

Now about the 20 lesions you have in your brain.  Do you know how big any of them are?  Are they all tiny and pinpoint?  How many episodes of pain and symptoms have you had?  Is any part of your neuro exam abnormal?  20 lesions does not make a diagnosis of MS.  The VEP sound normal (to me) and the LP was normal.

So, in order to qualify for meds for CIS you would need one episode of neurologic symptoms that are suggestive of a demyelinating lesion.  We know you have pain in your neck and a bulging disc.  What else do you have?

Quix