Another A&E thread

@MyOtherCarIsAPorsche I've read your thread from the start but not commented. I’m a lifelong migraine sufferer and my symptoms were identified as soon as I became verbal - so, very early indeed. I had 'classic' one-sided migraines throughout my whole childhood and adolescence but thankfully they tapered off in young adulthood, only to reappear around menopause in a different form, unfortunately. So I still have them after 60+ years.

I know you’ve had a lot of good and expert advice on this thread but I would highly recommend at least reading the guidance of the National Migraine Centre (fact sheet attached about migraine in children). They are the experts in this awful condition and I’ve consulted them. All their doctors are specialists and I’ve never spoken to any other doctor who 'got' what I was suffering from so completely and instantly. You could take DGD to see them with no judgment from any other medical professional and they would be able to offer a view on what exactly is happening. I honestly think that a 28-day headache in a 7-year old is very worrying and should be explored more urgently.

You do have to make a set 'donation' for their services as they are a charity. They’re in London but I believe they can do remote consultations now.

Best of luck. It sounds like a very concerning situation for you all, on top of your already-considerable worries.

My point was essentially that you’d think an optician would pick up on a squint, but my mother’s very experienced optician and Chelsea & Westminster ophthalmic dept failed to. I think they were so intent on looking into her eyes for the cause of double vision that they failed to stand back and look at them. (This was very recently btw)

In your case DG’s optician may have clocked it but not mentioned it nonetheless, because they don’t always cause vision problems and my niece’s self-resolved over time.

Treatment includes eye exercises, surgery to tighten the eye muscles so they align correctly. My mother was offered Botox injection to freeze the eye muscles but I don’t know if that’s offered to kids. She also has been prescribed some special prism lenses - but don’t know if they work yet as she’s not picked them up yet.

All this is rather by the by. The matter at hand is a month long migraine - with red flags for a brain tumour. Migraine should not be given as official diagnosis until full tests have been carried out and worst case scenario has been eliminated.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3562350/#:~:text=Ophthalmoplegic%20migraine%20is%20a%20rare,ptosis%20can%20also%20be%20observed.

Ophthalamoplegic migraine ( cranial neuralgia)

starts in kids, vomiting a feature

‘’Ophthalmoplegic migraine is a rare neurologic syndrome characterized by recurrent bouts of head pain and ophthalmoplegia. The third cranial nerve is most commonly affected, in which case mydriasis and ptosis can also be observed. Most patients recover completely within days to weeks, but a minority are left with persistent neurologic deficits. The disorder usually presents in children, but can persist in adulthood or persist into adulthood.2–4 Ophthalmoplegic migraine is entirely distinct from migraine with visual aura, in which patients experience transient visual phenomena before, during, or after the onset of migrainous headache.’’

But amblyopia tends to develop due to strabismus.

Ambylopia (lazy eye) and strabismus (crossed eyes) are slightly different.

Hard to tell from the pic but it looks like the left eye has a convergent squint.

Well my mother went to her excellent optician 3 times with double vision, he couldn’t find anything wrong with her eyes, sent her to hospital, they couldn’t find anything.

I pointed out she had a serious squint and took her to Moorfields and they say - oh yes strabismus and they’re adding a special lens to her glasses to help.

Has DH always had one pupil larger than the other?

OP I can’t believe what I’m reading on this thread and what you are all going through. I pray you can get a scan for your dgd soon, poor angel.

Apologies if it's stupid or already been said but since you have done so many checks with doctors etc could you get a dentist to check her out. I know the doctor looked at her teeth but they are not dentists. For example if you have an absess in your top gum your face can swell and your eye can shut because the inside of your mouth is swollen. The dentist can also check her throat. Since throats are connected to ears and noses there could be a connection. Ear problems can make you dizzy and feel sick. Maybe a daft idea but I'm always amazed what my dentist does - checking lymph nodes etc. It can't hurt and it would be something else crossed off. Best of luck to you and your family

If the headaches started before the glasses then there is no obvious reason to assume the glasses are an issue. You could double check when she will reach her full prescription if she hasn’t done already.
You could also ask about muscle tone around the eyes if the look lax.

Her eyes looking “weak” “lazy” - have they always been like that?

A squint/strabismus can cause double vision.

Sometimes with children they increase the glasses prescription incrementally especially as children can compensate for long sightedness better than adults. I think DS2 prescription started around +2 and eventually ended up at +6.5 where it has stayed for years.
He was under the supervision of a hospital ophthalmology department as he was at risk of a lazy eye and the gradually increasing prescription seemed to be the usual route.
We didn’t even realise how bad his vision was until he had his eyes tested because his older brother was.

She thinks, even if we investigate a private scan she will still be labelled as an unfit mother as she's questioning a diagnosis.

Doctors question diagnoses all the time. Why can’t she?

Thanks very much OP, very helpful.

So in summary:

She’s seen the GP about the October headache 3 x in total.
She’s been to the hospital in York once.
And 3 sets of glasses since June.

The paediatrician who said the drooping eyelid had ‘self-resolved’ (it hasn’t, it’s recurring) were they at the hospital? You haven’t had a separate paed appt? The paed she’s been referred to is in 3 months?

My advice would be the same as it was before either a. Make a private appt with a paediatrician or b. Go back to the hospital on the basis that symptoms have not resolved and she needs a scan.

@Lougle As indicated by the quote I responded to - the medical timeline only - GP, hospital visits.

Re the opticians. My partner went to the opticians for a routine check up and found in a year his vision had gone up by +2 from +3 to +5.
Perturbed he got another appointment with a different optician who came up with a number somewhere in the middle. The second optician said to a small degree a stronger position will make things clearer sometimes its hard to tell where the prescription is because the better/worse answer is blurry (no pun intended). He has kept with the lower prescription for a couple of eye tests since.

Just read through your thread OP. I’m so sorry you’re going through this. Your an excellent grandmother!!

Just two things to suggest but they may have already been suggested so apologies if so.

1. Have you guys considered just paying privately for an MRI? I know it’s expensive but it’ll cut out all this waiting around if it is something sinister and give you all peace of mind.

2. Not to sound goady/rude or anything, but is there any chance that your dgd is maybe exaggerating things? Maybe she did have a terrible headache for a few a days but then as a result of that got tons of attention from everyone so has prolonged this headache? From what you’re saying of her siblings, they have health issues which demands a lot of attention. So she may have felt ‘overlooked’ or sidelined before as her siblings got a lot of attention from family, mum and professionals. Now her having a prologoned headache is having that attention need met. If you see what I mean? Especially as it’s at night or in the mornings, when she is least distracted so maybe then ‘remembers’.
   That may sound insensitive and it doesn’t mean to read that way. I just know that siblings of disabled children can often be emotionally starved of attention unintentionally due to the needs of their siblings so can demonstrate their need for attention in different ways. Apologies if that reads coldly, it doesn’t mean too x

I remain surprised that the medical team hasn't requested a scan. I would have done.