Episodic double vision, blindspots/scotomas, dizziness, unsteadiness (no headaches)

Hi everyone, writing here so that I'm using all available avenues to research this problem. I've googled many times and patient.info came up quite often with some of my symptoms, but not all. Hopefully someone here has an idea about what this could be. Basically I stopped feeling fully "normal" sometime in October 2015. I'll just start at the beginning.

All last year I was extraordinarily busy at work, from January through August I was working six day weeks (occasionally seven). Aside from some tiredness and sleeping on my neck wrong over the summer (3-5 days discomfort) I felt great all year. At the end of the project I was on, I was given some time off, several weeks in fact.

I spent the time relaxing and working on my own projects/hobbies, drinking 3-6 cups of coffee a day (up from 2-3). The first Friday of my first week off, I had a dizzy spell. The following Monday I had an ocular migraine - squiggly scotoma with no headache. This caused me a fair amount of anxiety but passed. I then had 2-3 more ocular migraines that week, up from 1-3 a year. I saw my GP for annual checkup/blood work/blood pressure, all normal. In fact my blood work looked better than the previous year. I felt mostly normal too, and utlimately paid the scotomas little attention, continued on in life changing very little.

Mid-November, first Tuesday back at work after the time off, I got double vision for a few seconds. I probably should not have done so, but I googled double vision, and the results caused me to decide the ER was my best destination. They fortunately found nothing wrong, gave me an IV with calming medication, and a perscription for an antihistamine that was good for migraines. I explained that I don't get migraines, or headaches really, hardly ever. But I guess the symptoms sounded migraine-like.

Since then, I have felt varying degrees of normal but never fully normal. I had days where the front-top of my head felt tingly and tight all day. I had days where I felt woozy/unsteady on my feet all day. There was a moment at Thanksgiving dinner where I felt like I was sinking backwards suddenly but I was of course seated comfortably. Fortunately when those happen they only last a few seconds. Over Christmas I felt almost fully normal with my family (despite 3-5 scotomas during the two weeks)  but then suddenly got hit with a lightheaded-ness attack a few days into my visit. This one came while drinking a cup of Sumatra coffee (my third that day) and lasted a few seconds. I started to think excess caffeine was maybe my problem. I resolved that after the New Year I would get to the bottom of this.

As an experiment I had 3 cups of coffee my first day back, then switched to decaf French Roast. Halfway through the French Roast I had a dizzy spell so bad I had to grab onto my desk. OK, I thought. The little bit of caffeine present in the decaf coffee was enough to push me over the limit here. Caffeine it is. So I quit caffeine to see what would happen.

Two mornings later, I got double vision. This lasted like 15-20 seconds this time and was highly alarming. I consulted my opthamologist, he thought quitting caffeine was to blame, and he asked that I keep a symptom log. For a week I logged the scotomas/blindspots/visual oddities that I would get and sent him the results There were enough that he said "You should see a specialist" (I think I had 3-5 that week). The neuro-opthamologist examined my eyes (all normal) and sent me for an MRI which showed a white matter abnormality consistent with migraine patients.

I was then referred to a neurologist, he looked at the MRI and was unconcerned and said I shouldn't be either. After viewing my symptom log and the many visual disturbances, he felt this was all anxiety based. Meaning, the anxiety causes the migraines/blindspots, and the migraines/blindspots cause anxiety, in a loop. So I'm currently on 10mg of Celexa, just finished week 3. The celexa makes my head feel a bit swimmy sometimes. Otherwise I've noticed no changes or cessation of symptoms. In fact, I get multiple scotomas a day some days. Other days, I have none. Almost every day I get a single "firefly", which is consistent with migraine "aura". It's like a solitary glowing floater in my visual field. It travels left to right and bounces with my heartbeat. But I never get any migraine headache. I might get a headache on the double vision days, but on a 1-10 scale it's a 1.

I've become fairly frustrated but I am thankful that I am still functional and able to work. I'm also sleeping fine. I realize it could be a lot worse. It's really disconcerting to not feel like yourself though. Since quitting caffeine I've also adjusted my diet so it's healither, and after some internet research I'm taking 400mg of magnesium supplements (day three today - I asked my neurologist who perscribed the celexa if Magnesium was OK and he cleared it). So far though, no change. Had a couple of unsteady moments today in fact, and about 4 scotomas yesterday.

Anyway, if anyone has any ideas I am all ears. I have a follow up with the neurologist in a month. Thanks for reading this wall of text and for any advice/shared experiences.

PS - my scotomas last about 10 min and come in three categories -

- blobby afterimage like someone set off a camera flash

- squiggly glowing expanding scotoma like classic ocular migraine

- Fully-opaque blindness over a large portion of visual field, usually right eye (sometimes left), top half is covered like someone pulled down a windowshade

These all gradually return to normal over the ten minutes

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