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What Are Tests That Could Be Performed To Diagnose Without Requiring A Lumbar Puncture Or Is The Procedure Necessary?
Question: Hi,
My spouse initially had an episode two months ago of eye pain and dryness with vision loss which was thought to be dry eyes. This occurred immediately after a long flight.
However, after further checks and an MRI it is thought that the cause of the symptoms is optic neuritis behind the right eye as there is inflammation visible in the right optic nerve.
The vision has not yet recovered. We have seen an ophthalmologist and neurologist. The neurologist recommended a lumbar puncture to help diagnose the cause. Are there any other tests that could be performed to diagnose without requiring a lumbar puncture or is the procedure necessary? Can a blood test determine the cause as effectively as an investigation with a spinal tap? Does the lumbar puncture procedure normally require admission to a hospital for a few days?
Given that there was still eye pain during a flight a few days ago does this suggest on-going cause of inflammation whether the cause is auto-immune or infection?
Thank you.
My spouse initially had an episode two months ago of eye pain and dryness with vision loss which was thought to be dry eyes. This occurred immediately after a long flight.
However, after further checks and an MRI it is thought that the cause of the symptoms is optic neuritis behind the right eye as there is inflammation visible in the right optic nerve.
The vision has not yet recovered. We have seen an ophthalmologist and neurologist. The neurologist recommended a lumbar puncture to help diagnose the cause. Are there any other tests that could be performed to diagnose without requiring a lumbar puncture or is the procedure necessary? Can a blood test determine the cause as effectively as an investigation with a spinal tap? Does the lumbar puncture procedure normally require admission to a hospital for a few days?
Given that there was still eye pain during a flight a few days ago does this suggest on-going cause of inflammation whether the cause is auto-immune or infection?
Thank you.
Brief Answer:
Other tests, besides lumbar puncture, can be done.
Detailed Answer:
Hi,
I have read your question and understand your concerns.
Lumbar puncture is an examination that can be done in cases of optic neuritis is suspected to be associated with multiple sclerosis,
In my opinion, before lumbar puncture blood tests about erythrocyte sedimentation rate, thyroid gland functional tests, antinuclear antibody test, the level of angiotensin-converting enzyme, rapid plasma reagin test, mitochondrial DNA mutation studies, can be done to achieve a correct diagnosis.
Lumbar puncture is considered an outpatient procedure, it is not necessary for an overnight stay in the hospital.
Most likely optic neuritis is linked with autoimmune disorders.
I hope this helps.
Discuss with your Doctor these issues.
Feel free to ask if you have further questions.
Other tests, besides lumbar puncture, can be done.
Detailed Answer:
Hi,
I have read your question and understand your concerns.
Lumbar puncture is an examination that can be done in cases of optic neuritis is suspected to be associated with multiple sclerosis,
In my opinion, before lumbar puncture blood tests about erythrocyte sedimentation rate, thyroid gland functional tests, antinuclear antibody test, the level of angiotensin-converting enzyme, rapid plasma reagin test, mitochondrial DNA mutation studies, can be done to achieve a correct diagnosis.
Lumbar puncture is considered an outpatient procedure, it is not necessary for an overnight stay in the hospital.
Most likely optic neuritis is linked with autoimmune disorders.
I hope this helps.
Discuss with your Doctor these issues.
Feel free to ask if you have further questions.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Dear Dr. Spaho,
Thank you for your detailed advice.
I will discuss the blood tests that can be taken before or instead of doing a lumbar puncture.
Can the blood tests also confirm or rule out viral or bacterial infection which I am told may also cause optic neuritis. However, can an infection cause the condition for a duration of two months now? I understand that steroids are normally given in case of inflammation caused by an autoimmune condition but that they should not be given in case of active infection.
Can the blood tests also diagnose MS or is a spinal tap considered to be more accurate for diagnosis?
My spouse also had an episode of double vision caused by CN6 palsy a couple of years ago but has recovered. Does this make it more likely that her condition is linked to an autoimmune condition?
Thank you.
Thank you for your detailed advice.
I will discuss the blood tests that can be taken before or instead of doing a lumbar puncture.
Can the blood tests also confirm or rule out viral or bacterial infection which I am told may also cause optic neuritis. However, can an infection cause the condition for a duration of two months now? I understand that steroids are normally given in case of inflammation caused by an autoimmune condition but that they should not be given in case of active infection.
Can the blood tests also diagnose MS or is a spinal tap considered to be more accurate for diagnosis?
My spouse also had an episode of double vision caused by CN6 palsy a couple of years ago but has recovered. Does this make it more likely that her condition is linked to an autoimmune condition?
Thank you.
Brief Answer:
I would explain as follows.
Detailed Answer:
Hello again.
I have read your follow-up question.
Since two months have passed, an infection is less likely to be the cause.
Before mentioned tests and MRI findings should give the necessary information about the diagnosis and can distinguish between infection or autoimmune disorder.
A spinal tap may be necessary if these tests are inconclusive and MS is suspected.
Hope you found the answer helpful.
Let me know if I can assist you further.
I would explain as follows.
Detailed Answer:
Hello again.
I have read your follow-up question.
Since two months have passed, an infection is less likely to be the cause.
Before mentioned tests and MRI findings should give the necessary information about the diagnosis and can distinguish between infection or autoimmune disorder.
A spinal tap may be necessary if these tests are inconclusive and MS is suspected.
Hope you found the answer helpful.
Let me know if I can assist you further.
Above answer was peer-reviewed by :
Dr. Dr.Raju.A.T
Hi Dr. Spaho,
Thank you for your reply and information.
I understand that blood tests are the first step in diagnosis. Could you please kindly explain the function and diagnostic value of each blood test you have mentioned?
We had done these two following tests:
- Aquaporin 4 antibodies
- Myelin Oligodendrocyte Glycoprotein (MOG) antibody IgG.
Is there any crossover between these two tests and the mentioned blood tests?
Unfortunately the lab here came back with an error and in any case we may wish to do a full panel of blood tests as you have indicated.
Look forward to hearing from you.
Thank you.
Thank you for your reply and information.
I understand that blood tests are the first step in diagnosis. Could you please kindly explain the function and diagnostic value of each blood test you have mentioned?
We had done these two following tests:
- Aquaporin 4 antibodies
- Myelin Oligodendrocyte Glycoprotein (MOG) antibody IgG.
Is there any crossover between these two tests and the mentioned blood tests?
Unfortunately the lab here came back with an error and in any case we may wish to do a full panel of blood tests as you have indicated.
Look forward to hearing from you.
Thank you.
Brief Answer:
I would explain as follows.
Detailed Answer:
Hello again.
These tests aim to cover the range of the disorders that may cause these symptoms, including inflammation levels, thyroid gland disorders, and autoimmune disorders.
These tests and the ones that have been done, should give the necessary information about the diagnosis.
Feel free to ask if you have further questions.
Take care.
I would explain as follows.
Detailed Answer:
Hello again.
These tests aim to cover the range of the disorders that may cause these symptoms, including inflammation levels, thyroid gland disorders, and autoimmune disorders.
These tests and the ones that have been done, should give the necessary information about the diagnosis.
Feel free to ask if you have further questions.
Take care.
Above answer was peer-reviewed by :
Dr. LAKSHMI
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