Optic Neuritis or Ocular Migraine?
Posted: Fri Jan 27, 2017 5:17 am
So... I know that I'm just torturing myself by continuing to search the Internet before my husband has his VEP test, but I'd love to have someone weigh in on these "migraines" he's been having that first sent him to a neurologist.
Here's what's been going on. About two years ago, my husband began having migraines. These coincided with a new, very demanding job that he'd gotten, and so he chalked them up to stress. Fast forward to about two months ago when he began having visual symptoms. Basically, he couldn't see out of his right eye. He said it didn't hurt at all -- he just could only see a big black spot when he looked out of that eye only. This symptom came and went hour to hour over the course of a couple of days. And, two months after the symptoms began, I made him an appointment with a neurologist so he could get help for what we assumed (and what the original neurologist he saw assumed) were ocular migraines.
The neurologist sent him for an MRI without contrast and three lesions were found -- one of which was one centimeter. Out of concern for possible MS (and out of an abundance of caution) he was sent to have a host of lab work done, including a lumbar puncture. When the results of the LP came back he was found to have only one o-band, high protein (his level was 89; normal is 15-45), and elevated albumin. The neurologist then ordered a second MRI, this time with contrast, and the second MRI showed evidence of "Dawson's Fingers." Mainly because of this finding, the neurologist advised him to see a neurologist who specializes in the treatment of MS, and he had his appointment with this neurologist on Wednesday, Jan. 25.
The MS specialist called the findings on his MRI "concerning," but told him that his visual symptoms won't necessarily characteristic of optic neuritis. However, he still scheduled him for a VEP test, and that test is set for Feb. 8. If the results of that test come back abnormal, my husband will be diagnosed with MS (RRMS, more than likely). Until that time, and if the test results from the VEP test come back normal, he will keep his current diagnosis of radiologically isolated syndrome and have MRIs run every six months, beginning this coming July (unless another symptom crops up, in which case he will likely be diagnosed with MS at that point in time). (Obviously if future MRIs show new lesions, he would also be given a diagnosis of MS.)
Anyway, my question is, is what my husband experienced characteristic of optic neuritis? The MS specialist actually wrote down in my husband's chart "optic neuritis," but that may have been because they needed that diagnosis in order for insurance to cover the cost of the VEP test. I guess what I'm wondering is what the odds are that the results of that test will come back abnormal, based on his MRI and other tests he's had run? So far, all other disorders and diseases that mimic MS have been ruled out, although he does have some bloodwork that is still out.
Thanks in advance for any insight you can offer.
Here's what's been going on. About two years ago, my husband began having migraines. These coincided with a new, very demanding job that he'd gotten, and so he chalked them up to stress. Fast forward to about two months ago when he began having visual symptoms. Basically, he couldn't see out of his right eye. He said it didn't hurt at all -- he just could only see a big black spot when he looked out of that eye only. This symptom came and went hour to hour over the course of a couple of days. And, two months after the symptoms began, I made him an appointment with a neurologist so he could get help for what we assumed (and what the original neurologist he saw assumed) were ocular migraines.
The neurologist sent him for an MRI without contrast and three lesions were found -- one of which was one centimeter. Out of concern for possible MS (and out of an abundance of caution) he was sent to have a host of lab work done, including a lumbar puncture. When the results of the LP came back he was found to have only one o-band, high protein (his level was 89; normal is 15-45), and elevated albumin. The neurologist then ordered a second MRI, this time with contrast, and the second MRI showed evidence of "Dawson's Fingers." Mainly because of this finding, the neurologist advised him to see a neurologist who specializes in the treatment of MS, and he had his appointment with this neurologist on Wednesday, Jan. 25.
The MS specialist called the findings on his MRI "concerning," but told him that his visual symptoms won't necessarily characteristic of optic neuritis. However, he still scheduled him for a VEP test, and that test is set for Feb. 8. If the results of that test come back abnormal, my husband will be diagnosed with MS (RRMS, more than likely). Until that time, and if the test results from the VEP test come back normal, he will keep his current diagnosis of radiologically isolated syndrome and have MRIs run every six months, beginning this coming July (unless another symptom crops up, in which case he will likely be diagnosed with MS at that point in time). (Obviously if future MRIs show new lesions, he would also be given a diagnosis of MS.)
Anyway, my question is, is what my husband experienced characteristic of optic neuritis? The MS specialist actually wrote down in my husband's chart "optic neuritis," but that may have been because they needed that diagnosis in order for insurance to cover the cost of the VEP test. I guess what I'm wondering is what the odds are that the results of that test will come back abnormal, based on his MRI and other tests he's had run? So far, all other disorders and diseases that mimic MS have been ruled out, although he does have some bloodwork that is still out.
Thanks in advance for any insight you can offer.