Quote:
Originally Posted by glenntaj
--to see nerve damage to the optic nerve disc (head) on a good opthamologic exam, though the optic nerve is actually myelinated with the same myelin as the spinal cord, and therefore usually considered part of the central nervous system rather than the peripheral one, and certainly not a small fiber type nerve.
Generally when such damage is seen, it involves a "washing out" or "pale" optic nerve appearance, which generally means damage to the myelin, though there can be axonal damage as well.
Less profound optic nerve damage may be asymptomatic, but if it is extensive usually there are associated visual disturbances. The most common types of optic neuropathy/paleness in the Western world, especially among older people, are associated with diabetes, in which the mechanism is primarily ischemic/circulatory, and glaucoma, in which the mechanism is primarily compressive due to fluid build up. But potential causes are as wide ranging as the causes of other neuropathies. In particular, in younger patients, autoimmune, toxic, and nutritional deficiencies should be invenstigated.
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This interests me very much because my SFN appears to be progressing from numbness and tingle in my gums, lips and lower nose, up into my eyes. I don't know a lot about this apart from that optic neuritis is most commonly found in MS sufferers and is one of the diagnostic criteria I believe. I was found to have a flame haemorrhage close to my optic nerve by my last opthamologist. He explained that he found it a surprising discovery given that I don't have diabetes. He wrote to my GP suggesting that I was more closely monitored for hypertension. I was on oral steroids still at the time.
I see a new opthamologist next week and have passed on the image the last chap emailed to me. No one has commented on this flame haemorrhage or made any connection to my SFN but I am now on two BP meds. My vision isn't doubled or overly blurry but I do have trouble navigating if flooring is decorative or steps not very clearly defined and have to take all slopes in pigeon steps clutching a cane and where possible, walls and hand rails- and often misjudge doorways and feel very disorientated when lighting is low or if it changes. I have wondered if some of this might be visual because my eyes feel terribly tight and inflexible these days - I blink constantly and tear break up tests show significant lack of tears.
Sorry if these questions reduce the high minded discussion and information being shared here out of Starburst's post - but I'm also interested in learning how/ whether Dysautonomia is the same thing as Autonomic Neuropathy and to learn whether PoTS is always responsible? I am non-scientifically minded so am struggling to work all how much of this information and advice applies to myself. I don't have access to the caliber of expertise that some of you are seeking or are already benefiting from because of lack of funds and my Scottish location. However I am moving close by to one of the largest teaching hospitals in Europe very soon and the more I can understand about the distinctions between sensory polyneuropathy, autonomic neuropathy, dysautonomia and PoTS - if they are indeed distinct - the better.