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popstarrdiva 02-05-2009 10:27 PM

What does some slowing in the optic nerve mean on VEP?
Hi All,
So really confused. I am the one who now has had vertigo + tinnitus since Oct.08 + trying to see what is going on with me. Started with Optic Neuritis in 93....
So the MS Neurologist told me today that I have a slowing in my optic nerve on my evoked potentials, but my MRI's are always clean. He asked me about my eye and I said it is fine. I thought he was getting at the fact that I did have ON before, but I said yes, but last time I did this test it was normal. He replied, yes, well actually it was borderline. So I was bit mad that I didn't know that. So he wants me to go to a Neuro-Otologist to figure out the dizziness and go back to see him in Aug. I had volunteered to do a LP becuz I just want to know what is wrong with me has been since '93.
So, just wondering if anyone else has had this experience?
Could this mean I have anything else other than MS? ( I know I would still need 1 more pc of clinical proof)

MSNik 02-06-2009 06:58 AM

Re: What does some slowing in the optic nerve mean on VEP?
You can have optical neuritis and not have MS...I would go see a good NeuroOpahthamologist to begin with..someone who specializes in the nerves and diseases of the eye..and otologist is a hearing type doctor, who specializes in the ear, nose and throat.....if you are borderline MS and are looking for answers, this doctor wont be able to dx you...a NeuroOpthamologist on the other hand dx's MS regularly based on inflamation of the optic nerve. Keeping in mind, that MS is a disease which can affect the brain, spine and eyes...(central nervous system).

Good luck.

MSJayhawk 02-06-2009 10:35 AM

Re: What does some slowing in the optic nerve mean on VEP?
ON is the main symptom of MS among the majority of Japanese MS patients. Could it be MS, it would appear that more "looky-loo's" are needed. As you have had ON since 93, if you had MS I would think that your MRI would show lesions or scars from old lesions.

Your neurologist has given you some good advice. Follow the advice carefully. My VEP raised the alarm for my Neuro to order a follow-up MRI. At the time I had one MRI, but there were no active lesions. The second MRI was expanded to the cervical and thoracic spine where fresh lesions were found.

popstarrdiva 02-15-2009 01:24 PM

Re: What does some slowing in the optic nerve mean on VEP?
Thank-you so much for some answers. I had ON in 1993, but I was a child and what I have read is that pediatric MS presents differently than Adult onset. My book says that kids start out with a lot of sensory symptoms and very mild so it is harder to diagnose and takes years + years to catch it.
My family Dr doesn't want to send me to a Neuro-opthamologist right now. She wants the Vertigo + tinnitus sorted out first. So I am going to see my optomotrist and maybe an opthamologist again in the mean time.
Just hanging in here!
Thanks for reading

MSNik 02-15-2009 03:38 PM

Re: What does some slowing in the optic nerve mean on VEP?
First of all, not to be rude, but have you considered seeing a different family practice doctor? One who wont send you to a specialist is not usually the one you want to be seeing for this sort of thing. You need someone who will work with you.
Forget the optomotrist- he is useless to you and not a medical doctor. Go straight to the opthamologist. Ask him to look at your Optical Nerve and see if there is any inflamation...if there is, ask for a referral to a Neuro-Opthamologist as soon as possible. They can take months to get into see and your eyes arent something you want to play with, or wait on! Your family doctor is obviously gambling with your health not telling you to do this immediately.
Pediatric MS does not always include sensory symtoms, it can come on exactly like adult MS. In my MS groups, we have 3 kids under the age of 16 who were dx....your book- might not be up to date. Thats the thing about MS, each month they make new discoveries about MS and symtoms/ treatment of symtoms and drugs which are either being released, or in the testing stages. Books, are usually not a good source of info, unless they are really recently published..the internet, too- can be a bad source of info for the same reasons....some of (most of) what is published on the net is over 2 years old and virtually useless. Your ON in 93, could have been the first sign of MS...if it really was ON, its probably still showing signs of having occured. Its not unusual for the eye to fix itself, but the scarring is usually still there...a good doctor can see it. An optomotrist doesnt have the ability, he cant see behind your eye- nor is he medically trained to do so.
Good luck to you..

Bearygood 02-15-2009 04:35 PM

Re: What does some slowing in the optic nerve mean on VEP?
Hi, popstarrdiva. I'm not negating the possible importance of seeing a Neuro-Otologist but I would also strongly suggest you seeing an Ophthalmolgist rather than an Optometrist and that it would be MOST preferable to see a Neuro-Ophthalmologist. And preferably a Neuro-Op who has the an OCT machine (Optical Coherence Tomography). Taking this type of picture of the eye can be helpful in determining what's going on and at the very least, provides a good baseline. It's hoped that as OCT technology progresses that it can actually be some sort of predictor in disease progression -- some believe that it is now but my Neuro-Op's opinion is that it has a ways to go. It's also possible that a Neuro-Op might order an MRI of the optic nerve.

Regarding Optic Neuritis, it is [B]always[/B] suspicious for MS. There [B]are[/B] other things that can cause it but if you research the Optic Neuritis Treatment Trials (ONTT) you will see that the statistic of those who have had ON going on to get MS down the line is quite high.

I was dxed almost 2 years ago during a bout of ON (dxed by visual field testing, examination and MRI of the optics) and a brain MRI that showed lesions. I had unexplained and untreatable vertigo many years ago but it only lasted intermittently, over a period of about 18 months. There's no way of proving the vertigo from years ago was MS related but my MS specialist thinks that it was and that I've had MS for years without knowing it. What you said about sensory sx and children can be true for adults as well!

Good luck to you and please keep us posted.

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