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Confusing Neurological Symptoms. Have occular migraines, binocular diplopia and vertigo. Why is there unsteadiness and dizziness?

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Practicing since : 2001
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Confusing Neurological Symptoms..MS related? :

Thank you for taking the time to review my question. I am a 43 yr old female (non-menopausal) experiencing some strange symptoms, that seem to be neurological in nature and have me concerned that I may be looking at MS. A brief history: I have had occular migraines (migraine with XXXXXXX no headache) for over 20 yrs. These migraines happen about every 6 weeks and consist of flashing lights that last approx. 15 minutes. No headache has ever followed.
About 16 years ago I had a spontaneous episode of vertigo (room spinning) that lasted about 5 mins. I was pregnant at the time and the Dr's said it could have been pregnancy related. Five years ago I had a spontaneous episode of binocular diplopia, I was at a Dr's office and he asked me what was wrong with my eye, this lasted about 2 min's. Three years ago same thing, spontaneous binoc. diplopia that lasted 2 min's. This time I had an opthamologist do a full exam, he found nothing.
Last weekend, another episode of vertigo lasting 3 min's, followed the next day by migraine XXXXXXX Yesterday, a spontaneous episode of binoc diplopia lasting less than 1 minute. I tried to get to a mirror, but I did not notice any change in the position of my eyes.
In general I have had constant feelings of unsteadiness and mild dizziness, and my short term memory seems to be good, then not so good. Do any of these symptoms seem consistent with MS...It has been suggested that I have an MRI however I tried and couldnt get past the cage covering my head and they couldnt do the test. Please advise your thoughts when you have a moment.
Thank you.
Posted Sat, 21 Apr 2012 in Headache and Migraines
Answered by Dr. Shiva Kumar R 14 hours later

Your question is a very good one and I will work on providing you with some good information and recommendations.

Based on your information, you have three main problems - migraine headache, vertigo and diplopia.

Dizziness or vertigo is a common complaint among migraineurs. It can be seen in one third of people who have migraine. Vertigo usually lasts between 5 minutes and 1 hour—with or without nausea, vomiting, photophobia, or headache. These symptoms in the setting of a previous personal history or a positive family history of migraine support the diagnosis of vestibular or vertiginous migraine.
Diplopia which usually lasts less than a minute and nothing seen on examination may also be related to migraine (opthalmoplegic variant) itself.

However this can also occur in due to the brain stem involvement, one cannot completely rule out MS. To some extent I can presume that there is no MS; because we haven’t seen any new or progressive symptoms in you especially when you are not on treatment.

So to conclude, “I personally feel you have chronic vertiginous migraine with unexplained diplopia. MRI is the only investigation which can detect MS. You can talk to your primary physician / neurologist to confirm the same”.

I thank you again for submitting your question. I hope you found my response to be helpful and informative.

Dr Shiva Kumar R
Above answer was peer-reviewed by
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