
What Causes Trigeminal Neuralgia And Vision Loss Despite Having Normal MRI?

Seizures and polyradiculoneuritis to consider.
Detailed Answer:
Hello and thanks for using HCM.
I have read your query and understand your concerns.
Since the MRI resulted negative, there is no structural damage of brain and spinal cord ( malformation, tumors, stroke etc.).
The cause seems to be functional and hemiplegic migraine is one of the probable causes.
Another possibility that may explain such symptoms are seizures and polyradiculoneuritis or involved several nerve roots by a viral infection for example.
It is necessary to be evaluated by EEG and nerve conduction study together with EMG, in order to complete the necessary tests and to achieve a correct diagnosis.
Physical therapy is the best thing to do in recovery.
Hope you found the answer helpful.
Let me know if I can assist you further.
Greetings.


1) What would lead you to consider seizures? (Her younger sister also has FHM precipitated by a seizure-like aura but we never considered seizures for her)
2) Could a tick-born virus cause the radiculoneuritis that you mentioned (we live in an area endemic to tick-born viruses) or would it be a self-limiting virus that you would consider?
Thank you very much for your help!
Several viruses may be responsible.
Detailed Answer:
Welcome back and thanks for being on follow up.
I considered seizures because of the episodic changes of the symptoms and because of the difference in symptoms with previous ones.
Atonic seizures may result in such symptoms and evaluation is simple one with EEG.
Since there was a positive response to steroids, polyradiculoneuritis and even transverse myelitis of upper cervical spine should be considered. ( if MRI was done with intravenous contrast, transverse myelitis is very unlikely ).
There are several possible viruses that may lead to polyradiculoneuritis or transverse myelitis, including those you mentioned.
Hope I helped you.
Take care.

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