More on “The clinical spectrum of neuralgic amyotrophy in 246 cases”

There is an awful lot to absorb in The clinical spectrum of neuralgic amyotrophy in 246 cases .

My last main attack happened in Oct of 2006. In Nov of 2008, I had a sudden episode of blurry vision. By the time of my appointment to have this checked out, my vision had started to return to normal, and by the time my new glasses were ready, it was fine- and that particular prescription was never quite right for me. During the exam, the doctor found that one eye had pretty high intraocular pressure, and the other was a bit higher than what is considered normal. After a range of eye tests, and rechecks of my eye pressure, it was determined that I had glaucoma. When I asked specifically if the blurry vision was related to this, they said it was not. What was it then? No one has told me. But, it was the reason I went to the doctor only four months or so after my last most recent exam showed I had no problems.

What did I do? I assumed my previous eye doctor had messed up somehow, and not noticed my pressure had been increasing- or if they had noticed, that they did not tell me to watch it. I went back to them and got a print of my eye pressure readings over the last five years. It showed that the pressure was normal until 2006, and then started a slow rise with a peak in early 2008. The cause overall is not really known, but there are certain population groups that are statistically more likely to develop it in their lifetime. I was not in one of those groups. Why did I get it? Just lucky I guess.

Of course, one thing I thought of immediately was if NA or HNA could increase the chance I would develop some other disease, like glaucoma. I could not find, and still have not found any study or site that suggests a link. Blurry vision can be an early indication of up to 774 medical conditions according to Wrongdiagnosis.com, including glaucoma. Hmm. Maybe I need a new eye doctor too. Anyway, the one I was thinking of considering my other problems was optical neuritis, which can be a precursor to Multiple Sclerosis. Optical neuritis usually only causes blurred vision in one eye, and both of mine were blurred, so maybe something else was going on? But, was it was a stretch to think that a neurologic problem that caused a shoulder to go bad could also cause an eye problem? Since then, I have learned a lot about this particular problem though. It is never as simple as just saying that because the main complaint of those with NA is that they have right shoulder problems it means that any problems they have will be restricted to that area. As this study referenced shows, it can pretty much impact any nerve group any place. They say there is “no significant difference in clinical characteristics between INA and HNA patients, except for the age of onset and the total number of attacks, and possibly for the involvement of nerves outside the distribution of the brachial plexus, such as the phrenic, lumbosacral plexus, intercostals or cranial nerves, which has mainly been reported in HNA (van Alfen et al., 2000 )”.

I am not sure about the intercostals involvement, but that reference to cranial nerves jumped out at me. This is because the second cranial nerve is the optic nerve, and that may provide me the link I have searched for. If HNA/NA can involve the cranial nerves, it is not a real big stretch to think that it may have been the underlying cause for my case of glaucoma. Because if you look at the eye pressures I had as tested, they are about normal before Oct 2006, and then they start to climb. My blurred vision episode had been preceded by periods of eye pain, and tearing. Blurred vision can be a symptom of glaucoma.

I am curious if anyone else out there with HNA or NA has had vision problems.