Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes One-sided Eyesight Loss?
Question: I am in the process of getting a diagnosis following loss of sight in one eye--although now I'm having neuologic symptoms in my right arm as well (numbness, pain upon touch, extreme senstivitiy to cold) My neuro-opthamologist ordered an MRI but of course, I'm not due to see her for follow up for days. I have the results of the MRI--it indicates optic neuritis as her tests suggested as well. (The left and remaining optic nerve appear normal.) There are also "several periventricular lesions adjacent to the lateral ventricles with perpendicular orientation..." Obviously we're looking at MS or another demyelination disease (the lab results mention this as well). What I'm trying to learn is whether these results will tell me whether we're likely looking at MS or if it's NMO. There is no evidence of involvement of the corpus callossum and no evidence of infratentorial lesions. No abnormal contrast enhancement or diffusion restriction in any of these lesions or elsewhere in the brain. Thanks for your help. I understand that doctors have a million patients but when it's YOU suffering and scared, time seems to really sloooooow down! =) Thank you for helping me understand a bit of this!
Brief Answer:
MS more likely.
Detailed Answer:
I read your question carefully and I understand your concern.
Looking at that MRI report I believe that in your case multiple sclerosis is the most probable sclerosis. The reason for that is that usually neuromyelitis optica affects both eyes in a more severe way, though unilateral inclusion may happen as well. Also spinal involvement is very common in neuromyelitis optica although it may happen at a latter stage. The periventricular lesions are typical for MS and it is not said to find all those other imaging signs that you mention at the same time in initial exams, they depend on the stage and whether there are new plaques, previous ones do not enhance. So while neuromyelitis can't be completely excluded, MS is certainly more probable.
Anyway if you doctors are in doubt they might want to do a spinal tap with electrophoresis of the cerebrospinal fluid proteins to look for a feature called oligoclonal bands, typical for MS.
I remain at your disposal for further questions.
MS more likely.
Detailed Answer:
I read your question carefully and I understand your concern.
Looking at that MRI report I believe that in your case multiple sclerosis is the most probable sclerosis. The reason for that is that usually neuromyelitis optica affects both eyes in a more severe way, though unilateral inclusion may happen as well. Also spinal involvement is very common in neuromyelitis optica although it may happen at a latter stage. The periventricular lesions are typical for MS and it is not said to find all those other imaging signs that you mention at the same time in initial exams, they depend on the stage and whether there are new plaques, previous ones do not enhance. So while neuromyelitis can't be completely excluded, MS is certainly more probable.
Anyway if you doctors are in doubt they might want to do a spinal tap with electrophoresis of the cerebrospinal fluid proteins to look for a feature called oligoclonal bands, typical for MS.
I remain at your disposal for further questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
