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What Does My MRI Test Report Indicate?
Question: I am suffering from double vision. MRI shows no nasties but evidence of lack of blood flow but no permanent brain damage. Can you tell from the MRI when this damage took place. I had a TIA some 4 years ago and beleive that the current MRI shows this old TIA. Diagnosed with cranial palsy. lack of blood flow to 3rd ocular nerve in Dec 2013. No further test done. Became so ill obtained second opinion and was diagnosed with MG. Suffered breathing crisis, broken bones when total nerve system shut down. Loss of swallow, chewing, speech and muscle weakness throughout body. all known to the specialist. Optometrist advised specialist I had MG but went ahead with eye lid surgery.
Second opinion found MG within 5 minutes and admitted to hospital. Double vision and eye lid droop disappeared within 36 hours of correct treatment. Why was MG not found in the place
Second opinion found MG within 5 minutes and admitted to hospital. Double vision and eye lid droop disappeared within 36 hours of correct treatment. Why was MG not found in the place
Brief Answer:
Myasthenia gravis seems to be responsible for all the mentioned problems.
Detailed Answer:
Thanks for asking on HealthcareMagic.
I have gone carefully through the details provided and I think that myasthenia gravis can explain it all, from the double vision to the breathing crisis and total nervous system shutdown as you call it. This disease is caused due to autoimmune damage to receptors of nerve stimulus or certain other proteins involved in the process. Hence it is unlikely to bring changes that would be evident in an MRI. Needless to say that it is not possible to date a change that is not evident.
Eye muscle weaknesses are characteristic of this disease and the lack of coordination of the eye muscles on either side may lead to double vision. I have doubts about how effective the eye surgery would be, as the cause remains. Since myasthenia was the cause, the vision showed improvement with treatment for myasthenia. If there is lack of blood flow to the 3rd cranial or oculomotor nerve, then that perhaps is something additional and unrelated. The risk factors for the same however could be associated with the transient ischemic attacks (TIAs). TIAs may or may not always be evident in an MRI. Hence it might be difficult to date the changes from an MRI.
The diagnosis of a disease depends on the clinical suspicion. Hence an optometrist could not have diagnosed it.
Hope that helps.
If you found my answer helpful, please close the thread with a positive review and a 5 star rating.
Regards
Dr. Kunal Saha
Myasthenia gravis seems to be responsible for all the mentioned problems.
Detailed Answer:
Thanks for asking on HealthcareMagic.
I have gone carefully through the details provided and I think that myasthenia gravis can explain it all, from the double vision to the breathing crisis and total nervous system shutdown as you call it. This disease is caused due to autoimmune damage to receptors of nerve stimulus or certain other proteins involved in the process. Hence it is unlikely to bring changes that would be evident in an MRI. Needless to say that it is not possible to date a change that is not evident.
Eye muscle weaknesses are characteristic of this disease and the lack of coordination of the eye muscles on either side may lead to double vision. I have doubts about how effective the eye surgery would be, as the cause remains. Since myasthenia was the cause, the vision showed improvement with treatment for myasthenia. If there is lack of blood flow to the 3rd cranial or oculomotor nerve, then that perhaps is something additional and unrelated. The risk factors for the same however could be associated with the transient ischemic attacks (TIAs). TIAs may or may not always be evident in an MRI. Hence it might be difficult to date the changes from an MRI.
The diagnosis of a disease depends on the clinical suspicion. Hence an optometrist could not have diagnosed it.
Hope that helps.
If you found my answer helpful, please close the thread with a positive review and a 5 star rating.
Regards
Dr. Kunal Saha
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Most helpful. My GP referred me to an Eye Specialist whose expertise is in Macular Surgery and diseases of the eye.
He ordered the MRI and no other tests.
To my knowledge MG is a neurological disease rather than an Eye disease.
The MG was undetected for 13 months and was discovered when I obtained a second referral from a neurologist.
My question is did the Eye Specialist have the necessary training and experience to diagnose or should he have referred me to a neurologist in the first place.
Double vision and droopy eyes seem to have the symptoms when confined to ocular nerves. Cranial palsy affecting the eyes seems to me to be a minor problem corrected with prism glasses, whilst MG can be fatal if not treating.
Should the priority be to also check for the most severe disease.
He ordered the MRI and no other tests.
To my knowledge MG is a neurological disease rather than an Eye disease.
The MG was undetected for 13 months and was discovered when I obtained a second referral from a neurologist.
My question is did the Eye Specialist have the necessary training and experience to diagnose or should he have referred me to a neurologist in the first place.
Double vision and droopy eyes seem to have the symptoms when confined to ocular nerves. Cranial palsy affecting the eyes seems to me to be a minor problem corrected with prism glasses, whilst MG can be fatal if not treating.
Should the priority be to also check for the most severe disease.
Brief Answer:
Follow the directions of your neurologist.
Detailed Answer:
Thanks for writing back. Sorry for not being able to write back earlier.
I do not think that the eye specialist should be blamed. The diagnosis of a disease depend on the clinical correlation and what the mind does not know, the eyes do not see. Myasthenia gravis is not a very common condition that general physicians would see frequently. So, for eye specialists, it would be even rarer. So, it might not have crossed the eye specialist's mind about myasthenia or a neurological referral. I would not blame him although a neurological referral would indeed have been appreciable.
I do not think that you should be on the lookout for other major diseases.
Hope that helps.
If you found my answer helpful, please close the thread with a positive review and a 5 star rating.
Regards
Dr. Kunal Saha
Follow the directions of your neurologist.
Detailed Answer:
Thanks for writing back. Sorry for not being able to write back earlier.
I do not think that the eye specialist should be blamed. The diagnosis of a disease depend on the clinical correlation and what the mind does not know, the eyes do not see. Myasthenia gravis is not a very common condition that general physicians would see frequently. So, for eye specialists, it would be even rarer. So, it might not have crossed the eye specialist's mind about myasthenia or a neurological referral. I would not blame him although a neurological referral would indeed have been appreciable.
I do not think that you should be on the lookout for other major diseases.
Hope that helps.
If you found my answer helpful, please close the thread with a positive review and a 5 star rating.
Regards
Dr. Kunal Saha
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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