I am 35, female. Are my eye issue and spine problem related?

Question

Hello doctor,

I am a 35-year-old woman who suddenly lost vision in my left eye three weeks ago, and it still has not fully returned. Last month, I had severe back pain and weakness in both legs that made walking difficult for several days. I also experienced uncontrollable hiccups and nausea that lasted for over a week, which my doctor thought was strange. My MRI showed some changes in my spinal cord, and now I am scheduled for more tests. Could these symptoms all be connected to one condition?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Your symptoms, like sudden vision loss in one eye, acute severe back pain with leg weakness, and prolonged hiccups with nausea, combined with magnetic resonance imaging (MRI) findings of spinal cord changes, suggest a central nervous system disorder that affects both the optic nerves and spinal cord. One possibility is neuromyelitis optica spectrum disorder (NMOSD), an autoimmune condition in which the body attacks the optic nerves and spinal cord, causing optic neuritis (sudden vision loss) and transverse myelitis (back pain, limb weakness, difficulty walking). The persistent hiccups and nausea could indicate involvement of the brainstem area controlling vomiting, which is characteristic of neuromyelitis optica spectrum disorder.

Other conditions, such as multiple sclerosis, certain infections, or vascular issues, can sometimes cause similar symptoms, but the combination of optic, spinal, and brainstem involvement over a short period raises suspicion for an inflammatory autoimmune disorder.

Further testing includes blood tests for aquaporin-4 antibodies and myelin oligodendrocyte glycoprotein antibodies, repeated magnetic resonance imaging, and possibly a lumbar puncture to examine cerebrospinal fluid.

Early diagnosis is crucial because treatments such as immunosuppressive therapy can prevent further attacks and permanent disability. Given the severity and combination of your symptoms, it is important to follow up promptly with a neurologist specializing in demyelinating disorders.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.