This Is MS Multiple Sclerosis Knowledge & Support Community

Hi all,
I am new to this forum but just wanted some advice on whether I should get a second opinion from a different neurologist or not. I have had symptoms over the past nine months which has led me to my gp, eye doctors and a neurologist. It started with eye pain in the morning when I would move my eye, which then progressed to daily migraines. Eye docs all told me my eyes were perfectly healthy until finally I went to an eye ER and they diagnosed me with strabismus (eyes drifting outward but only slightly). This has caused my depth perception to come and go and causes major eye strain when using the computer. I am getting a prism built into my glasses which is supposed to help. The neurologist has sent me for an MRI which came back as few punctate foci of the subcortical region consistent with migraine, vascular, inflammatory or demylination. I also have some muscle weakness in my left leg that comes and goes from day to day and hand tremors which also seem to come and go. The neurologist says that I have ocular migraines but did an EMG and nerve conduction test on my legs which she said was normal. She just did that today and I have tingling in my left leg but not my right even though she zapped both? Also should mention that my thyroid is enlarged but my TSH and T4 levels are in the normal range, so not sure if these symptoms are related to a thyroid problem.
Would you seek a second opinion from a neurologist?
Oh and I have chronic achilles tendonitis as well.
Any input would be appreciated!!!
Thanks,
Amy

I also should mention that these symptoms started while I was using Aldara prescription creme for a precancerous skin lesion. It is an immune modulator and after I started having weird symptoms I read the side effect profile and it stated that it could exacerbate MS symptoms.

Welcome to ThisIsMS, Amy. We cannot dispense medical advice here, but we can offer suggestions from one friend to another. I am a firm believer in second opinions. Start with your GP or internist, someone you trust and who is willing to work with you as a "disease detective." If necessary, find a new one. I think it is more logical to use your GP as your case manager; he may be more appropriate for conducting a baseline thorough physical exam and blood tests. His appointments are less costly (and more easily scheduled in a timely manner) than the specialists (neurologists) and a GP may actually be better at recognizing or ruling out conditions with similar symptoms.

Discuss with your GP the possibility of insulin resistance (your leg muscle cells may be insulin resistant and not allow glucose, which is your energy source, to enter the cells; could this be the reason for your left leg weakness?). You mentioned leg weakness and hand tremors seem to come and go; have you noticed if this coincides with eating sugar?

You mentioned having an enlarged thyroid – most physicians do not test beyond the Free T4 hormone level, if it appears in the normal range; it is more thorough to test for Free T3, Total T3, Reverse T3, and antithyroid antibodies as well. With the enlarged thyroid, you may well have a problem there. In fact, some people think MS (though this is probably not your diagnosis) symptoms are caused by thyroid hormone imbalance (for example, The MS Solution by Kathryn R. Simpson).

All the best.

Thank you for the advice. Went to the gp today with my symptoms list. Since the emp test on Monday I have had constant numbness and tingling in left leg. She listeners asked if the neurologist thought MS and gave me a prescription for a 5 day steroid pack and is sending me for some blood work including a sed rate test. My thyroid antibody test came back in the normal range. So we will see if the steroids help. Thanks again.
Amy

Squidbaby,

You said that you were having pain in the mornings in one of your eyes. You were diagnosed with strabismus. Do you have one eye that turns out, or are both eyes turning out? Essentially, I am trying to divine whether or not you have an exotropia (outward turned eye) or an exophoria (both eyes struggle to maintain normal alignment and tend to turn outward). An exophoria could certainly cause strain with computer viewing. Essentially your eyes want to maintain an outward posture and have to strain to stay turned inward with a close viewing distance. Prism in the glasses moves the image you see slighlty outward thereby helping your eyes from straining to try and align inward as normally they should do. Ok, this is likely way more complicated then you care about, but what I am trying to decide is if you are having pain in an eye that could be an optic neuritis type of incident or precursor, or simply misalignment that causes strain.

Eye doc
I was diagnosed with exophoria ( both eyes turning out slightly). I have now seen five eye docs and not one of them can explain why I have eye pain in the morning! I take 800 mg of ibuprofen before bed and it doesn't hurt so much in am. I forgot to take it the other night and I was hurting more in the morning. I was given a field vision test the end of jan when this pain became chronic and was told I passed.
The MRI showed no inflammation of the optic nerve or orbital cavity.
I have had bad eyes since I was 6, but have never had these problems before. I am now 39.
My left eye is also the one that has really bad astigmatism. Don't know if that makes a difference.
Thanks in advance
Amy

That type of eye pain could be optic neuritis related, but I would doubt it. It should be more consistent throughout your day than just in the morning. Asthenopia is the term we use for eye pain like yours...as in "she has eye pain but heck if I know why". It is very common to have unexplained pain like that, but there are still other possibilities, chief among them in my mind would be a sinus blockage in the frontal sinus which is next to the eye socket. With no MRI finsings, clear VF, and normal vision you are definitely not having optic neuritis, although you should still be monitored closely. Best of luck