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6th Cranial Nerve Palsy Recurrence -- anyone?
I posted this in Neurology as well -- I am curious if anyone has a similar story to mine & if so, have you had any luck in identifying the root cause.
I had a 6th nerve palsy in 2008 after the birth of my 2nd child. My right eye would not full move outward causing double vision. This cleared on its own in about 3 weeks time and a brain MRI w & wo contrast came back clean.
The issue recurred this past September (6 years later!), but this time, my left eye would not fully move to the right resulting in double vision. In addition, I had significant eye pain when moving my eyes, trouble with eyes tracking together laterally, oscillopsia, dizziness & balance issues, vision distortion, floaters, plus other fun things.
The double vision cleared in about 3 weeks again (had it when looking right at first, then when looking left). The rest of the symptoms took another 3-4 weeks to clear.
MRI/v of brain w and wo contrast are normal
Cervical & Thoracic spine MRI shows a non-enhancing T2 signal @ C3 plus a more subtle non-enhancing signal @ C4-5 (no mass effect)
Neuro-ophthalmology tests were all fine when I went in. No noticeable issues with either the optic nerve or my vision.
Vestibular testing all came back fine.
Gobs of blood tests -- only abnormal results are an elevated ACE and CRP.
I still have significant pain when I look up and some residual dizzy/balance issues that are annoying. I also am suffering extreme fatigue 2.5 months later plus back pain and random tingling/buzzing/pain in my extremities.
My concern is that this 2nd occurrence left me almost completely home-bound for 3 weeks and unable to drive for another week after that. I travel for work & cannot imagine if this had happened while I was on the road! No one seems to know why it has happened and/or if it will happen again.
If anyone has a similar story and/or resolution/Dx that you could share, I would really appreciate it. I feel like I am "tested out" and just looking for any similarities from others in the community.
Thank you!
I had a 6th nerve palsy in 2008 after the birth of my 2nd child. My right eye would not full move outward causing double vision. This cleared on its own in about 3 weeks time and a brain MRI w & wo contrast came back clean.
The issue recurred this past September (6 years later!), but this time, my left eye would not fully move to the right resulting in double vision. In addition, I had significant eye pain when moving my eyes, trouble with eyes tracking together laterally, oscillopsia, dizziness & balance issues, vision distortion, floaters, plus other fun things.
The double vision cleared in about 3 weeks again (had it when looking right at first, then when looking left). The rest of the symptoms took another 3-4 weeks to clear.
MRI/v of brain w and wo contrast are normal
Cervical & Thoracic spine MRI shows a non-enhancing T2 signal @ C3 plus a more subtle non-enhancing signal @ C4-5 (no mass effect)
Neuro-ophthalmology tests were all fine when I went in. No noticeable issues with either the optic nerve or my vision.
Vestibular testing all came back fine.
Gobs of blood tests -- only abnormal results are an elevated ACE and CRP.
I still have significant pain when I look up and some residual dizzy/balance issues that are annoying. I also am suffering extreme fatigue 2.5 months later plus back pain and random tingling/buzzing/pain in my extremities.
My concern is that this 2nd occurrence left me almost completely home-bound for 3 weeks and unable to drive for another week after that. I travel for work & cannot imagine if this had happened while I was on the road! No one seems to know why it has happened and/or if it will happen again.
If anyone has a similar story and/or resolution/Dx that you could share, I would really appreciate it. I feel like I am "tested out" and just looking for any similarities from others in the community.
Thank you!
Thank you, achillea. Looks like I need to make another appointment with another neurologist.
The symptoms of MS can wax and wane for years, and by that I mean *decades* before a clear cut diagnosis is delivered. You might want to Google the bejesus out of MS--and try not to be too fretful if you do not get an instant diagnosis, assuming that your constellation of symptoms is more annoying or mystifying than actually debilitating.
However, we should never discount the significance of 5th cranial nerve problems OR migraine variants. I am not joking. A very, very good neurologist should be able to walk you through the likelihood that your symptoms are more--or less--related to one condition or the other. The differential diagnosis in things neurological can be quite difficult.
However, we should never discount the significance of 5th cranial nerve problems OR migraine variants. I am not joking. A very, very good neurologist should be able to walk you through the likelihood that your symptoms are more--or less--related to one condition or the other. The differential diagnosis in things neurological can be quite difficult.
Achillea,
Sadly, no, nothing has been ruled in or out. I haven't received a diagnosis at all, except for strabismis, which I actually still have.
MS was of course mentioned, but with a clear mri, that was not pursued anymore. No one even offered a lumbar puncture or nerve tests, although an LP sounds awful, so that might be a good thing.
If what I had sounded like TN, that makes me wonder about MS again, because I think that can be a symptom. I wonder if I should call my neurologist about that. Only problem is that the symptoms cleared.
Sadly, no, nothing has been ruled in or out. I haven't received a diagnosis at all, except for strabismis, which I actually still have.
MS was of course mentioned, but with a clear mri, that was not pursued anymore. No one even offered a lumbar puncture or nerve tests, although an LP sounds awful, so that might be a good thing.
If what I had sounded like TN, that makes me wonder about MS again, because I think that can be a symptom. I wonder if I should call my neurologist about that. Only problem is that the symptoms cleared.
When one-sided headaches are involved, the possibility of migraines and migraine 'variants' should always be considered. These headaches can occur on either side, though in chronic migraineurs, there tends to be a 'favorite' side for the pain. In some types of migraines, there can be stroke-like symptoms, such as slurring or losing words. There was a rather famous case a while back of a TV announcer who had one of these while broadcasting live.
Diplopia and other disturbances of sight can also be a feature of some migraines, like the rare type called Ophthalmoplegic Migraine.
Jolting pain around the jaw and cheek is absolutely classic for Trigeminal Neuralgia, also called "tic douloureux," an irritation of the fifth cranial nerve. (Actually, the trigeminal nerve has three branches, serving the upper, middle, and lower portions of the face, so the function of all branches of the nerve deserves to be checked out thoroughly.)
I assume that both migraine and trigeminal neuralgia have been ruled out in your case?
Diplopia and other disturbances of sight can also be a feature of some migraines, like the rare type called Ophthalmoplegic Migraine.
Jolting pain around the jaw and cheek is absolutely classic for Trigeminal Neuralgia, also called "tic douloureux," an irritation of the fifth cranial nerve. (Actually, the trigeminal nerve has three branches, serving the upper, middle, and lower portions of the face, so the function of all branches of the nerve deserves to be checked out thoroughly.)
I assume that both migraine and trigeminal neuralgia have been ruled out in your case?
Hello! I have a similar story to share as well, although I have no idea what caused mine, since my MRI was clean as well. I had two separate "episodes." For the first one, I had tingling and numbness in my pinky and ring finger as well as nystagmus in the morning which lasted about 10 minutes each morning and then cleared. Went to the doctor, was told lots of silly things, gave up, and went about my life.
About six months later, I had a terrible headache in my right eye that lingered for about a week. I had pain with eye movement as well. Then, I started having double vision and noticed that my left eye drifted out. I went to an ophthalmologist and was diagnosed with strabismus. Vision was fine, so no optic neuritis. Got an MRI, though, after that, which was totally clean. I've seen neurologists, neuro-ophthalmologists, and ophthalmologists, and I have yet to receive a single diagnosis except for the strabismus that was visible in my exam. No one seems to have an answer, no one wants to pursue a diagnosis, and, frankly, no one seem to care.
Since then, a few weeks ago actually, I had another headache that lasted about week and gave me pretty severe jolting pain around my jaw and cheek that lasted about a second or so. But I didn't go back to the doctor because I knew I'd just get some crappy explanation, like I'm just stressed. I've also had pretty crushing fatigue in which I slur my words and find it difficult to find the right thing to say.
I just hijacked your thread. Sorry! But I'm interested to know what doctors told you, since I've had a couple of the same symptoms as you.
About six months later, I had a terrible headache in my right eye that lingered for about a week. I had pain with eye movement as well. Then, I started having double vision and noticed that my left eye drifted out. I went to an ophthalmologist and was diagnosed with strabismus. Vision was fine, so no optic neuritis. Got an MRI, though, after that, which was totally clean. I've seen neurologists, neuro-ophthalmologists, and ophthalmologists, and I have yet to receive a single diagnosis except for the strabismus that was visible in my exam. No one seems to have an answer, no one wants to pursue a diagnosis, and, frankly, no one seem to care.
Since then, a few weeks ago actually, I had another headache that lasted about week and gave me pretty severe jolting pain around my jaw and cheek that lasted about a second or so. But I didn't go back to the doctor because I knew I'd just get some crappy explanation, like I'm just stressed. I've also had pretty crushing fatigue in which I slur my words and find it difficult to find the right thing to say.
I just hijacked your thread. Sorry! But I'm interested to know what doctors told you, since I've had a couple of the same symptoms as you.
If you have Cranial Nerve Palsy, the muscles that move the eyes are affected too. There is a blockage of blood flow to the nerves between the brain stem and muscles within the eye socket. That is why you experience double vision and it's possible to have a droopy eyelid. You need to visit and ophthalmologist to evaluate your eyes. He may recommend patching your eye or you will be prescribed prism glasses.
Thank you, achillea. I appreciate the response. I don't know what board I belong on these days and thought I would see if my story resonated with anyone here or in the General neurology board.
I noticed that you have posted in the MS Community, and I think that's a good thing. Your answers will probably be found in that area.
MS is so mysterious and so highly individual, and the symptoms wax and wane so unpredictably and often after long symptom-free intervals! Do keep reading and informing yourself on this subject.
There is excellent info on the Web MD site devoted to MS (if the censor here even allows me to mention that).
MS is so mysterious and so highly individual, and the symptoms wax and wane so unpredictably and often after long symptom-free intervals! Do keep reading and informing yourself on this subject.
There is excellent info on the Web MD site devoted to MS (if the censor here even allows me to mention that).
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