I think my potentially unknowledgable neuro-ophthalmologist has caused such bad stenosising that I’m hemiparesised
Starting in August of 2024 I started having neurological symptoms that just made no sense. No neurologists could figure out what was wrong leading to misdiagnoses of psychological problems and attempts at pushing diagnoses like FND on me. Eventually I met a general neurologist who agreed to a lumbar puncture, and he found my opening pressure was 30. He explained anything over 20 was considered borderline high, and anything over 25 was considered severely high and for sure IIH. He also discussed how almost all my symptoms were typically symptoms of IIH and matched the puzzle pieces. He started me on 250mg of diamox once a day and 100mg of topimax twice a day right away. He then referred me to neuro-ophthalmology to get better IIH care and have my vision issues checked out since I was having vision issues. The medicine seemed to work a little bit but not much during the 4 months waiting for neuro-ophthalmology. I was getting frustrated and wondering if needed a higher dosage, but general neurology weirdly enough wouldn’t mess with the dosage until I see neuro-ophthalmology. I finally get in to see this guy and he agrees with the diagnosis. He talks about how he review all my MRIs and I had empty sella in all of them. He runs a lot of eye tests and discussed how I have “residual water markers” on my eyes “which means that at one point” I had “high papilledema” and that they “left small damage on my eyes”. He discusses how I even still have grade 1 papilledemas. He also diagnoses me with IIH. I’m like cool, and start mentioning that I feel I might need higher dosage of medicine because I keep having black out moments with my eyes… and his whole domineer changes. He starts discussing how 30 is considered only “borderline high” and that he has “patients who are at 60”. He then tells me that with “only grade 1 papilledemas” that my “case is considered only mild” to “his standards” and that “I shouldn’t need medicine because my symptoms shouldn’t be severe”. I feel caught off guard and start telling him with the general neurologist said. The neuro-ophtamologist kinda rolls his eyes and insists he “is much more knowledgeable in IIH then the general neurologist” and tells me I need to see a headache specialist because he feels like my IIH caused headaches are actually “complex migraines” and that all these IIH symptoms are are “something else entirely”. He takes me off my diamox entirely, and then cuts my topimax in half and says he will only put me back on medicine if my “papilledemas show me I need it” and sends me on my way very confused with a 3 month follow up. At this point I say screw it and do my own research where it’s suggesting every thing that he is saying is a load of belong and there is even people with IIH who don’t get papilledemas at all and this guy is about to ruin my life probably. He does order a MRV which comes back positive for “mild bilateral narrowing of the junction of the sigmoid and transverse”. Now I learned all narrowing of the veins for people with IIH should be referred to a neurointerventionalist to have pressure gradiented as just because it’s described as mild narrowing doesn’t mean the pressure isn’t build up and it’s actually not mild. So I message him asking if he will be referring me to a neurointerventionalist to have the narrowed vein looked at. He said it was not necessary as “Eveyone with IIH has bilateral narrowing veins” and that “it’s a normal common finding and doesn’t require treatment”. I am like ??? Wth ????
After this happens my general neurologist suddenly drops me and says I don’t need to be under his care anymore because “he isn’t specialized in IIH like a neuro-ophthalmologist is”. I feel completely confused about this too. Keep in mind they both work within the same university hospital so idk if they like said something to each other or what happened. So I’m left with no neuro care what so over for 3 months. As these 3 months go on my symptoms return and worsen. I’m talking the worst neck and shoulder pain of my life. The worst headaches. I pay out of pocket for a headache specialist as the referred headache specialist said it will be over a year to get in. She’s been doing this for over 25+ years and clocks immediately that I’m having IIH caused headaches. She continues prescribing my current dosage of topirimate and adds 25mg of topirimate to help with the headaches but I don’t notice much of a difference. Eventually I find myself in the hospital after a god awful pressure like headache happens and causes the same pain in my neck and shoulders. Then the next day comes around and the left side of my face goes numb, the eye feels like it’s gonna pop out my head (but both eyes hurt awfully bad), I can hear th heart beat in my left ear and my ear is muffled, it’s painful down the front of my neck now too on the left side only, and now I’m getting sharp pain down the side.
I’ve been through to a few ER centers and they keep just ruling out stroke and TIA and going idk. Did get admitted at one er place who ignored me when I told them about my IIH diagnosis, I think because they pulled the record from the neuro-ophthalmologist at the university hospital and it’s literally like “yeah I think she has a mild case of it but not severe enough to cause severe symptoms”. They eventually ran out of time with the insurance company and tried to say it was a hemiplagic migraine and should “clear up in a few days” and it did not clear up in a few days…. It’s been 4 weeks and no improvement. In fact the pain is worsening. The hospitals fid acknowledge papillledemas though and did seem confused why I was not on medicine so they gave me diamox and topimax because they’re saying I should be on medicine. I have a potential second opinion with a neuro-ophthalmologist recommended in a IIH group but I’m on his waiting list right now unfortunately. I also have an appointment with a neurointerventionalist on August 11th which I got by asking for a second opinion and basically begging them for help. I’m not sure if this was the move but the ERs are no longer doing anything but giving me migraine cocktails (which are ineffective) and phoning in like 5 narcotics and telling me to see “my pcp” which works for the same university and won’t refer me outside the university. I’m in the process of looking for another pcp but it takes fine.
What do you guys think? IIH related?