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Mother Diagnosed With Optic Neuritis. MRI Was Clear. Experiencing Pins And Needles In Feet And Fingers. What To Do?
Question: Hello Dr. Grief, I am a 47 year old mother of two. About three weeks ago I was diagnosed with Optic Neuritis and immediately had an MRI which was clear. THe opthamologist said not to worry too much about MS but follow up with Neurologist at home (I was out of town at the time.) I also have experienced pins and needles in just my feet and fingers off and on for the past 6 months or so. I realize it could be other things, like Diabetes, Lupus. I also contracted Fifth Disease from my small son about 5 years ago and got an acute onset episode of RA and have had arthritis like symptoms in hands and feet ever since but have not followed up with doc about that. BUt I have read Fifth Disease can cause OPtic Nueritis but has it been too long? Also my mother has had Autoimmune Issues (hepatitis, skin rashes) but is a healthy 88 and I also have two cousins with Lupus. I guess I am really scared of MS and am hoping it will be something else! Thank you and sorry for long email
Hi,
Thanks for writing in.
This is Dr Vivek replying to your question.
From your history, you are a 47 years old lady diagnosed with optic neuritis three weeks back. MRI scan (probably brain) was also done. There is also a mention of you contracting Fifth Disease from your child. There has been acute joint pains and some sort of arthritis. There is a strong history of Autoimmune conditions in your family.
Coming to Fifth Disease, it is caused by Parvovirus B19 infection. Other than Fifth Disease, this virus also causes painful or swollen joints (polyarthropathy syndrome), which is more common in adults. This can cause a temporary stop in generation of new red blood cells. this becomes a problem only in those with decreased general immunity or in those suffering from sickle cell disease or similar types of long-lasting anemia. You also might have had the joint symptoms due to this. There is no clear mention of optic neuritis and Fifth disease being associated years apart.
There is a disease known as Devic's disease in which features of simultaneous inflammation and demyelination of the optic nerve (optic neuritis) and the spinal cord (myelitis). This does have an autoimmune issue and I strongly suggest that this needs to be evaluated and ruled out in your situation. Devic's disease is a rare disorder which resembles multiple sclerosis (MS) in several ways, but requires a different course of treatment.
I suggest you have a discussion with your neurologist on this and get yourself clinically examined. They may also ask you to get a MRI scan of spinal cord done as a necessary investigation depending on your clinical results.
Further questions welcome.
Hoping for the best.
Regards,
Dr Vivek
Thanks for writing in.
This is Dr Vivek replying to your question.
From your history, you are a 47 years old lady diagnosed with optic neuritis three weeks back. MRI scan (probably brain) was also done. There is also a mention of you contracting Fifth Disease from your child. There has been acute joint pains and some sort of arthritis. There is a strong history of Autoimmune conditions in your family.
Coming to Fifth Disease, it is caused by Parvovirus B19 infection. Other than Fifth Disease, this virus also causes painful or swollen joints (polyarthropathy syndrome), which is more common in adults. This can cause a temporary stop in generation of new red blood cells. this becomes a problem only in those with decreased general immunity or in those suffering from sickle cell disease or similar types of long-lasting anemia. You also might have had the joint symptoms due to this. There is no clear mention of optic neuritis and Fifth disease being associated years apart.
There is a disease known as Devic's disease in which features of simultaneous inflammation and demyelination of the optic nerve (optic neuritis) and the spinal cord (myelitis). This does have an autoimmune issue and I strongly suggest that this needs to be evaluated and ruled out in your situation. Devic's disease is a rare disorder which resembles multiple sclerosis (MS) in several ways, but requires a different course of treatment.
I suggest you have a discussion with your neurologist on this and get yourself clinically examined. They may also ask you to get a MRI scan of spinal cord done as a necessary investigation depending on your clinical results.
Further questions welcome.
Hoping for the best.
Regards,
Dr Vivek
Above answer was peer-reviewed by :
Dr. Raju A.T
Dr. XXXXXXX
As far as Devic's disease. I only had severe arthritis symptoms for a few days five years ago when I contracted Fifth Disease. I have mild arthritis symptoms that are only present during inactivity and go away once I start moving for the day. I researched the Devic's disease and it doesn't sound like something I might have. Also my Optic Neuritis has improved a lot and just a mildly blurry now.
But I will mention this to my doctor when I go for exam. I also read that is its very rare and typical patient is of Asian or African descent I am neither.
Thank you
As far as Devic's disease. I only had severe arthritis symptoms for a few days five years ago when I contracted Fifth Disease. I have mild arthritis symptoms that are only present during inactivity and go away once I start moving for the day. I researched the Devic's disease and it doesn't sound like something I might have. Also my Optic Neuritis has improved a lot and just a mildly blurry now.
But I will mention this to my doctor when I go for exam. I also read that is its very rare and typical patient is of Asian or African descent I am neither.
Thank you
Hi,
Thank you for the update.
Glad to know that your optic neuritis has improved considerably. I don’t think your arthritis has any role in the development of optic neuritis. Its nice to hear that you have done an extensive research on Devic’s disease and are almost certain that your complaints differ in presentation. Nevertheless, I strongly suggest you have a word on that with your neurologist and express your awareness about this rare disease.
You have rightly said that Devic’s disease is very rare in occurrence, but that’s the only condition closely resembling MS, along with features of optic neuritis. Besides, I had also kept your family history of autoimmune disorders in mind.
Hoping for the best.
Wishing you good health.
Regards.
Dr Vivek
Thank you for the update.
Glad to know that your optic neuritis has improved considerably. I don’t think your arthritis has any role in the development of optic neuritis. Its nice to hear that you have done an extensive research on Devic’s disease and are almost certain that your complaints differ in presentation. Nevertheless, I strongly suggest you have a word on that with your neurologist and express your awareness about this rare disease.
You have rightly said that Devic’s disease is very rare in occurrence, but that’s the only condition closely resembling MS, along with features of optic neuritis. Besides, I had also kept your family history of autoimmune disorders in mind.
Hoping for the best.
Wishing you good health.
Regards.
Dr Vivek
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Raju A.T
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