Vertical Double Vision

[Rena705]

I was diagnosed with MS in 1996, presenting with grand mal seizures, had MRI and L.P. have been on 400mg/daily Tegretol since, in remission until this year, diagnosed with Paratrigeminal Neuralgia in Feb. 2007,ice pick pain in right temple, drooping left eye with numbness in left side of face, was given IV Steroids, weaning Prednisone increase in Tegretol gradually for pain, tried Topamax, didn't help symptoms, started on Neurontin, increasing dosage to 1600mg/day which is what I am on now along with 1200mg/day Tegretol, 6 Extra strength Tylenol/day.  Started suffering from severe pain in hands in July 2007, x-ray done, normal.  Started suffering from severe muscle spasms in legs in July 2007, October MRI of spine & pelvis, normal. Began suffering from severe vertical double vision Nov. 7, went to ER, CT done, normal, Tegretol drug levels done, normal.  My question is this, what might you think may be causing the severe vertical double vision?  I was told by the ER doctor that this is not normally a symptom of MS and since there was no pain involved it makes it even less likely to be part of your MS.  Thank you for taking the time to answer my question.

[Rena705]

I took your advice and saw my Opthamologist yesterday.  He did a full exam and had stated that my vertical double vision is related to MS.  He said that while this is a rare symptom of MS especially since  had no pain involved as well he is convinced that it is MS.  I had previously told my Neurologist that the Opthamologist stated that all the problems I was having with my eyes including blurred vision and regular double vision were related to MS but the Neurologist said that "No, it is your eyes, it is not MS."  I told the Opthamologist what the Neurologist said and he asked who my Neurologist is and I told him and he was surprised and stated that he and this Neurologist don't normally bump heads on diagnosis.  I asked the Opthamologist to please send a report of his findings to the Neurologist and the Opthamologist said that yes, he would.  
I had an MRI this last Monday as well and am now waiting the results.  It will be interesting to hear what the Neurologist has to say now.  I will let you know!
Thanks for your advice!
Rena 705

[Anant10]

Hi,

There could be many reasons for vertical diplopia. It could be due to involvement of optic (eye), occular motor (eye muscles) or vestibular system (responsible for balancing). Involvement of cranial nerves, especially III and IV can result in vertical diplopias. Certain neoplasms and inflammation of cavernous sinus may also be responsible. It is advisable that you see your neurologist.