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What Causes Worsening Disequilibrium, Double Vision And Fatigue
Question: I have disquilibrium that has gotten worse in the past week, double-vision, dropped some things (because of the disequlibruium), and fatigue. I have been to my primary care doctor, who did blood work and found nothing, went back to the the PA at my PC office, who diagnosed vertigo and told me to do "Epley" exericise. Saw the PA in my Neurologist's office last week (for a routine check up as she deals with my chronic migraines), told her all of this (on Monday) and on Friday she called in a prescription for Hydroxicine (sp?). I took it once and that was enough--did not like how it make me feel--very out of it. Went to ER on Friday of last week b/c I wanted to know what was going on. They did CT Scan, Chest xray, blood work, urine test--and found nothing. Today, the ENT found nothing, said it was not ENT related vertigo but seemed neurological to him and sounded like Multiple Sclerosis. I am skeptical since it seemed more of a catchall and that he couldn't help me and just said that, rather than actually knew. He gave me the names of two neurologists next door to him at a Sleep Clinic. I had a "Clean" MRI two years ago when the migraines got bad. I will schedule an appt with a full-on neurology institute (rather than my migraine doc) but at this point I am frustrated that a doctor has just dumped MS as a possibility right before the holidays when I won't get any answers until January. I know two people with MS--very close to me--not related by blood. Thank you for your time. AS
Brief Answer:
Possibilities explained
Detailed Answer:
Hi
I am Dr Mittal
I have read your query
I think I may be able to help you.
I have understoof your query and will come directly to my suggestions
With double vision and disequilibrium, I would consider an ophthamological evaluation as well. there may be some kind of eye disorder in the play too. This may be causing double vision or diplopia and therefore the disequilibrium as well.
I will agree with your idea of meeting the neurologist. However, I dont agree with the choice of study. MRI would be a better choice of investigation than a CT scan. The complaints of diplopia and imbalance, if neurological in origin suggest a part of the brain that the CT scan can bareky cover - the posterior part of the brain (PCA territory medically speaking). I therefore agree with you to meet a neurologist and plan further treatment. I wont consider MS so soon in your case however. It needs multiple episodes of complaints- and from the query, i surmise this is the first episode.
However, in the current symptoms, I would not consider the MRI that is 2 years old. That was then and told us about the features at that time. May not be the same now.
I would also consider migraine as a cause of you current symptoms- its called acephalgic migraine where you have the other symptoms but no headache. Your regular medications for acute migraine should help you with that.
I hope that the information helps.
Please feel free to contact me for any further information
Best of luck
Dr Mittal
Possibilities explained
Detailed Answer:
Hi
I am Dr Mittal
I have read your query
I think I may be able to help you.
I have understoof your query and will come directly to my suggestions
With double vision and disequilibrium, I would consider an ophthamological evaluation as well. there may be some kind of eye disorder in the play too. This may be causing double vision or diplopia and therefore the disequilibrium as well.
I will agree with your idea of meeting the neurologist. However, I dont agree with the choice of study. MRI would be a better choice of investigation than a CT scan. The complaints of diplopia and imbalance, if neurological in origin suggest a part of the brain that the CT scan can bareky cover - the posterior part of the brain (PCA territory medically speaking). I therefore agree with you to meet a neurologist and plan further treatment. I wont consider MS so soon in your case however. It needs multiple episodes of complaints- and from the query, i surmise this is the first episode.
However, in the current symptoms, I would not consider the MRI that is 2 years old. That was then and told us about the features at that time. May not be the same now.
I would also consider migraine as a cause of you current symptoms- its called acephalgic migraine where you have the other symptoms but no headache. Your regular medications for acute migraine should help you with that.
I hope that the information helps.
Please feel free to contact me for any further information
Best of luck
Dr Mittal
Above answer was peer-reviewed by :
Dr. Yogesh D
Answered by
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