Brief Answer:
Possible aura of aborted migraine vs. early sign of myasthenia gravis

Detailed Answer:
Good afternoon. Thank you for your question.

As a VA Neurologist and Director of the Headache Center in XXXXXXX OH...your symptom reminds me of 2 things:

1. Visual aura of what we would call an ABORTED MIGRAINE and those are definitely known to happen.....
2. Early stage of myasthenia gravis (one of the most commonly early noticeable symptoms) being that of double vision due to extraocular muscle weakness.

Of course, there could be other things such as what your wife said which is hypoglycemia....but why would that only happen during winter and summer months?

On the visual aura diagnosis that would take a bit more history and perhaps your filling out a headache diary for a few weeks to get details of not only the double vision but other symptoms you may not be aware of since it is happening to you.

If you want to think about myasthenia gravis (MG) then, a couple of lab tests looking for Antibodies to Acetylcholine Receptors is one way to go. A more sensitive but more invasive test...but it really gets at the diagnosis would be something called SINGLE FIBER REPETITIVE STIMULATION done with an EMG machine. This is a very sensitive test and if POSITIVE is very suggestive of MYASTHENIA GRAVIS.

Of course, other metabolic things SHOULD BE RULED out such as thyroid disease or disorder as well as one other very rare disorder that can occur during seasons and that could be something called PERIODIC HYPERKALEMIC PARALYSIS or something a bit rarer and genetic called PERIODIC HYPOKALEMIC PARALYSIS.

Those would be more accessible as diagnoses if you could draw blood and measure potassium levels during an attack of blurriness.

Here are a few associated risk factors:

strenuous exercise, high carbohydrate meals, meals with high sodium content, sudden changes in temperature, and even excitement, noise, flashing lights and induced by cold temperatures. Weakness may be mild and limited to certain muscle groups, or more severe full body paralysis. Recovery is usually sudden when it occurs, due to release of potassium from swollen muscles as they recover. Some patients may fall into an abortive attack or develop chronic muscle weakness later in life.

Do any of those risk factors describe anything from your end?

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