The exact pathophysiology of migraines remain unknown, but research suggests that these patients may have overactive neurons in their brains and brainstems resulting in vascular fluctuations, aura and pain.2 The prevalence of migraines with aura is highest in 30- to 50-year-old Caucasian women.2 Research shows that 70% to 90% of patients with migraines have a positive family history.2 Patients with migraines have a higher risk of stroke, especially those who experience aura.2 The distinguishing feature of a migraine from ischemia or seizure is prodromal tingling and numbness, which can start five to 30 minutes before visual aura.1 Headache commonly follows aura and is typically unilateral and throbbing in nature.2 The headaches may be accompanied by nausea, vomiting, photophobia and phonophobia.2, The most common type of aura with migraine is a type of visual phenomena called scintillating scotoma.1 This is often described as sparkling zigzag lines with adjacent blurry, wavy, or missing areas of vision. Yes. Policy. They asked me to hang in there for the last 9 minutes. Elselvier; 2018. https://www.clinicalkey.com. Treatment depends on the severity and frequency of the migraines. My Optometrist has no idea why this would happen. There are many factors to consider when managing such a patient and optometrists need to be ready to do so efficiently. Headaches may be accompanied by nausea, vomiting, light sensitivity, pulsatile tinnitus, and neck and back pain.13 The headache with IIH is usually worse in morning and may have a positional component. decided optic nerves are probably normal for me and blurred vision is due to migraine . symptoms now 2 yrs. To solve the MRI vertigo puzzle, Roberts and his fellow researchers in the lab of John's Hopkin's neurologist Dr. David Zee put 12 volunteers -- 10 with healthy inner ear balance centers and 2 without -- in MRI scanners, tracking what they reported feeling and simultaneously monitoring any involuntary eye movements that indicate the brain is registering motion. Your patient reports that their vision went dark for a couple of seconds in one eye and then went back to normal. Gadopentetate is given by injection before MRI to help diagnose problems in the brain, spine, head, neck, tissues, and other parts of your body. Kidney disease, severe (acute or long-term)Should not be used in patients with this condition unless your doctor specifically tells you that it is necessary. Optometrists are tasked with determining the etiology of sudden, reversible bouts of vision loss. Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked. By entering your email and clicking Sign Up, you're agreeing to let us send you customized marketing messages about us and our advertising partners. The patient had no neurologic symptoms and was found to have left internal carotid artery dissection on a magnetic resonance angiogram. Ann Neurol. Had the same thing happen. Accessed Sept. 25, 2019. You could have dry eyes if your vision improves when you blink. We do not endorse non-Cleveland Clinic products or services. persisting 12 weeks. Optic neuritis: The eye as a window to the brain. I can get that kind of thing happening, but actually its nothing to do with the MRI. Kellerman RD, et al. Varifocals prescription Have you had an arthrocentesis (aspiration) of a join where they drew some synovial fluid from a Nerve conduction study, has anyone ever had one, anyone ever had a disciplinary for being ill, eyes- optician unable to correct my vision so all images (close and far) are blurry. Sometimes squinting will bring things into focus. Treatments may include: These products treat blurriness brought on by refractive errors and other causes, including cataracts. Bakri S, Capone A, Ciulla T, et al. Know what to expect if you do not take the medicine or have the test or procedure. My eyes were closed. My symptoms began with blurry vision. Dec. 4, 2019. Pineles SL, Balcer LJ. Clinical Decisions in Neuro-Ophthalmology. Sadun A, Currie J, Lessell S. Transient visual obscurations with elevated optic discs. If MRI is contraindicated, computed tomography (CT) can be done instead. Have you noticed problems with movement and coordination or numbness or weakness in your arms and legs? You are also agreeing to our Terms of Service and Privacy Policy. CBC with differential may reveal normochromic normocytic anemia, elevated platelet count or increased inflammatory components in GCA patients.6,7, Patients with GCA are routinely placed on high-dose intravenous corticosteroids to control inflammation and manage symptoms.6 Vision loss due to AION is considered a neuro-ophthalmic emergency that needs immediate intervention to prevent blindness and involvement of the other eye. check out the. After a few weeks, it may go away on its own and your vision will return to normal. Lisabyday in reply to Tigywnkle 2 years ago I'm glad I found this thread. feeling like something is in your eye. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. An MRI scan can only detect gross lesions of the brain. It may also occur idiopathically as in idiopathic intracranial hypertension (IIH). Stone J, Tuckwell K, Dimonaco M, et al. In these cases, your doctor may want to change the dose, or other precautions may be necessary. 1984;16(4):489-94. In some cases, you may not need any treatment for optic neuritis. An MRI can also rule out other causes of visual loss, such as a tumor. Inflammatory optic neuropathies and neuroretinitis. Some symptoms include: your eyes twitching a drooping eyelid seeing double You may also experience: difficulty. Ask your patient about what they were doing when the vision loss occurred and be sure to verify any recent changes to medications. Has anyone ever had an arthrocentesis of a joint affected by ra. Non-pharmacologic treatment includes eliminating trigger factors, stress management and biofeedback. Use eye drops to lubricate your eyes if theyre dry or irritated. A complete medical exam may help your healthcare provider find other health conditions that can be treated. May increase the likelihood of serious side effects. When the optic nerve is irritated and inflamed, it doesn't carry messages to the brain as well, and you can't see clearly. It occurs when your optic nerve is inflamed. Over the years I have probably had at least a dozen MRI's with a couple done during a flare with optic neuritous. But on the 4 hour drive home I had severe vision impairment. Im glad I found this thread. Supposed chronic migriane . Most people regain close to normal vision within six months after an optic neuritis episode. An 82-year-old man presented to the eye clinic with a concern about recent episodes of transient vision loss. Diagnosis of IIH is ultimately established using the Modified Dandy Criteria.13, Lumbar puncture can temporarily relieve symptoms or completely resolve papilledema in a patient with IIH.13 Patients should be advised to lose 5% to 10% of body weight and modify their diets to increase the chances of remission.13 Pharmacologic agents such as acetazolamide and furosemide aim to decrease the production of CSF and may have a diuretic component for increasing outflow of CSF. Magnetic resonance imaging (MRI) of the head is a painless, noninvasive test that produces detailed images of your brain and brain stem. When I came out of the appointment I couldn't focus on distant objects my vision was blurred with a bit of double vision. Certain injuries and medical. . Treatment depends on the cause. I had a MRI earlier today and I had blurry/ double vision for about 30 minutes. TMVL related to migraines tends to last longer and have a gradual onset with a duration of up to one hour.2, Papilledema is a bilateral thromboembolic event that tends to cause quick, one- to two-second bouts of vision loss.1 Thromboembolic-causes of TMVL can last from one to 15 minutes.3, Provoked/Unprovoked. Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of gadopentetate injection in children 2 years of age and older. In: Ophthalmology. You may have another health condition that's causing it. I would strongly recommend a 24-hour Gadolinium urine test (if they used a contrast agent with gadolinium and not iodine). If you have eye pain or any trouble with your vision, see your doctor for an eye exam. It is recommended that specimens are at least 2cm to 3cm in length due to potential skip lesions.6 The distal and proximal ends of the artery are clamped with titanium clips. Gadopentetate is a gadolinium-based contrast agent (GBCA). Has anyone ever had blurry vision after MRI? In some cases, steroid medications are used to reduce inflammation in the optic nerve. With glaucoma, fluid build-up in the eye puts pressure on the optic nerve. Other forms of TMVL with migraines are hemianopsias and monocular vision loss.5 In young patients, transient hemianopsias are more often related to migraines than to an embolic transient ischemic attack.5 Transient monocular vision loss due to a migraine will more frequently present with positive visual symptoms in contrast to totally blacked-out monocular vision loss due to an embolus.5, All patients with new migraines and visual aura should have their visual fields assessed. - was put in in all my clothes and jewelry, no padding around the walls and my arms, and told to rest my left arm on top of my leg. http://www.merckmanuals.com/professional/eye-disorders/optic-nerve-disorders/optic-neuritis. Roberts said magnets' effects are a minimal issue in the clinical settings in which MRI machines with lower-strength magnets are typically used, though his colleague Zee added that in certain procedures, doctors rely on functional imaging to make sure they're not working in parts of the brain critical for speech or movement. The medications will vary depending on your underlying disease. Anyway, I'm OK now. I had one today and it happened to me too. I was 45 minutes in the barrel. An MRI with contrast is an imaging test that combines magnetic and radio wave imaging with an injection of a contrast agent (dye). Yes, I have blurry vision that lasts for 1-2 hrs after MRI without contrast. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding. This is especially true if youve been injured or if you have any other symptoms of stroke, such as difficulty speaking or moving. Dont think it was anything to do with position and I was quite happy no stress involved etc. 5 The episode generally lasts for one to 15 minutes until the blockage disperses and blood flow is restored. Non-permanent damage can occur when the high blood sugar in the blood causes more fluid to flow into the lens of the main. By rejecting non-essential cookies, Reddit may still use certain cookies to ensure the proper functionality of our platform. Get MD to check glucose. These types of conditions can be medical emergencies and include: You should get medical help immediately if your vision gets blurry quickly and/or if you have sudden vision loss. Blurry vision may happen when your eyes are tired or irritated, or it may be a symptom of a more serious condition. Headaches occur in 98% of cases of papilledema.13 They can be in any location and occur daily. Cookie Notice In: Liu, Volpe, and Galetta, ed. National Eye Institute. They called the MRI people. MRI scans are a special kind of diagnostic procedure that use magnets and computers to create images or pictures of certain areas inside the body. Other symptoms were dizziness, facial numbness, dried mouth and cognitive dysfunction. www.asrs.org/content/documents/fact-sheet-29-retinal-artery-occlusion.pdf. I had the scan due to migraines. At first I couldn't read anything though. Patients who have had prior reactions to contrast mediaUse with caution. When the nerve fibers become inflamed, the optic nerve can also start to swell. Accessed Sept. 23, 2019. This swelling typically affects one eye, but can affect both at the same time. Pula J, Kwan K, Yuen C, et al. 6. A special kind of MRI exam, called magnetic resonance angiography (MRA), examines the blood vessels. Ask if your condition can be treated in other ways. Whats your next move? 9. mri did not show anything and my back have been hurting. Above symptoms happen from the arahnoid cy Migraine may well be the most obvious cause for headache, but the persistence of visual blurring for 2 weeks troubles me. He/she might listen. What happened to you wasn't ON. These may be symptoms of NSF. Philadelphia, PA: Elsiver; 2019:101-196. MRI of the brain is helpful after an initial episode of ON because the number of lesions seen can stratify the patient's risk for developing clinically definite (CD) multiple sclerosis (MS) after a clinically isolated syndrome (CIS). You're likely to see an ophthalmologist for a diagnosis, which is generally based on your medical history and an exam. Layers of the elastic lamina within the vessels are destroyed by lymphocytes and multinucleated giant cells and inflammation causes narrowing of vessel lumens.6 The prevalence of GCA is three times higher in women than men and most patients are 70 years or older.6 It is uncommon for patients to have GCA if they are younger than 50.6 Research suggests a genetic component may be in play, due to a higher incidence of GCA in Caucasians and an association with HLA antigens.6, Optic nerve infarction tends to manifest as multiple episodes of TMVL before potentially inducing permanent blindness.5 Multiple episodes of TMVL are more likely due to GCA than an embolic cause.5 Transient binocular diplopia and other visual phenomena have been reported in addition to TMVL.6 Approximately 80% to 90% of vision loss in patients who have GCA is due to anterior ischemic optic neuropathy (AION) and the second eye tends to become affected within days in 75% of untreated patients.6, Between 16% and 26% of patients will have visual complications without any systemic symptoms, but the examiner should inquire about headaches, scalp tenderness, jaw claudication when chewing or talking, fever, weight loss and polymyalgia rheumatica.5,6 The most common of these symptoms are headaches and jaw claudication. Optic neuritis. Am Soc Retina Specialists. Infection, severe orUse with caution. By using our website, you consent to our use of cookies. Felt good afterwards. We performed a temporal artery biopsy on the right side since visual symptoms were in his right eye. Has anyone else experienced this? 5th ed. HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. You may feel lightheaded or faint when you stand up after youre lying down. The dye highlights blood vessels, organs, and specific soft tissues so they show up more clearly and help your radiologist determine a diagnosis. Some conditions will cause blurriness to come on suddenly. Dr. Tran is a fourth-year optometry student at Pacific University. Meltzer E, et al. There are many signs and symptoms associated with POTS. neuro exam fine . ON doesn't come on and go away in a few minutes or a few hours. Connect with a U.S. board-certified doctor by text or video anytime, anywhere. What are the possible side effects of the medications you're recommending? In: Zitelli and Davis' Atlas of Pediatric Physical Diagnosis. Pharmacologic treatment is divided into acute (abortive) therapy and prophylactic (preventative) therapy. A strong magnetic field is created by passing an electrical current through. According to Roberts, the biggest consequence of their discovery that magnetic fields put pressure on the fluids in the inner ear could come in the research world. IBM Micromedex. Your doctor will treat it with eye drops, and it could take weeks or months to. This happened to me literally as soon as I left the machine. What a horrifying experience! 3. With me its to do with the position I am lying in on the MRI table,and having to lie still for so long - in particular the way my neck and head is positioned. I just had 3 MRI scans in a row of neck and back. What is a head MRI? Intravenous steroid therapy quickens vision recovery, but it doesn't appear to affect the amount of vision you'll recover for typical optic neuritis. Vision changes are often described as a monocular or bilateral graying out, with episodes usually only lasting a couple seconds.14 Patients with papilledema may also experience binocular horizontal diplopia due to a lateral rectus (CN VI) palsy.13 Visual phenomena such as flashes of light have been reported in 54% of cases and permanent vision loss in 32% of untreated cases.13 Chronic, untreated papilledema can lead to field defects that mimic the damage caused by glaucoma.15. Portions of this document last updated: Feb. 01, 2023, Original article: https://www.mayoclinic.org/drugs-supplements/gadopentetate-intravenous-route/side-effects/drg-20074688. Internist for Diabetes, Hyperparath You have two medical problems that exist simultaneously and independently. I had the exact same thing happen. Need to distinguish between episodic and chronic migraine patterns as different preventative meds may be indicated. Are you ok now? Embolic causes of transient monocular vision loss: Appearance, source, and assessment. This article provides a by-the-numbers overview of the information youll want to collect, both historical and clinical, how to obtain it and how to interpret it to protect your patients vision. Take a family member or friend along, if possible, to help you remember the information you're given. Cloudy vision, or hazy vision, also means that you cant see things clearly. Get useful, helpful and relevant health + wellness information, 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event, (https://www.aao.org/eye-health/symptoms/blurriness-2), (https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/214028s000lbl.pdf), (https://www.healthdirect.gov.au/blurred-vision), (https://www.merckmanuals.com/professional/eye-disorders/symptoms-of-ophthalmologic-disorders/blurred-vision), (https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/refractive-errors), Visitation, mask requirements and COVID-19 information, Postural orthostatic tachycardia syndrome (POTS). Alright!!! Ferri FF. I could barely walk! For carotid emboli, the carotid artery can be assessed with conventional angiography, a Doppler ultrasound, magnetic resonance angiography or computer tomography angiography.5 Cardiac evaluation including electrocardiography and 24-hour heart monitoring is warranted in cases of cardiac emboli.5 Neuroimaging of the head may also be indicated to look for any emboli in the brain.5, There is no standard treatment for retinal artery occlusions. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. Another common cause of blurred vision is dry eyes. Abnormal opening pressures greater than 25cm H2O in adults and 28cm H2O in children up to age 18 may suggest a diagnosis of IIH.13 An analysis of CSF should be conducted as well as a CBC to further rule out other causes of intracranial hypertension. Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. It can affect one or both eyes. It's possible for the optic nerve to be inflamed without affecting vision. Hi Olevet99, yes vision was fine a few hours after and no problems since. Also using a bit of voltaren gel on my neck helps. Hopefully, either neurology or neurosurgery is already involved. Symptoms may worsen if you are hot, for example, after playing sport or showering. In: Liu, Volpe, and Galetta's Neuro-Ophthalmology. Optic neuritis can affect both adults and children. Evaluation of optic nerve sheath fenestration in pseudotumor cerebri using automated perimetry. These injectable medications are used for people at high risk of developing MS. Possible side effects include depression, injection site irritation and flu-like symptoms. Ask your doctor if you have any questions. Yesterday's vision loss, however, did not result in a migraine. In These cases, steroid medications are used to reduce inflammation in the blood causes more fluid to flow the! May help your healthcare provider find other health conditions that can be treated in other ways U.S. board-certified doctor text..., Dimonaco m, et al magnetic resonance angiogram U.S. board-certified doctor text. Symptoms and was found to have left internal carotid artery dissection on a magnetic resonance angiogram symptoms associated POTS... A window to the brain on does n't come on and go on... Analytics and advertising purposes theyre dry or irritated, or hazy vision, means. Speaking or moving see an ophthalmologist for a couple done during a flare with optic neuritous is restored symptoms! Be treated in other ways use certain cookies to ensure the proper functionality of platform! Build-Up in the optic nerve sheath fenestration in pseudotumor cerebri using automated perimetry that... Not intended for individual diagnosis, treatment or prescription back to normal Physical diagnosis problems since neck and.! What they were doing when the blurred vision after mri loss in some cases, your doctor for eye... You stand up after youre lying down during a flare with optic neuritous the right side since visual symptoms dizziness! After an optic neuritis episode conditions will cause blurriness to come on suddenly clearly! A U.S. board-certified doctor by text or video anytime, anywhere the right side since visual symptoms were dizziness facial! They asked me to hang in there for the last 9 minutes fibers become inflamed, the optic.!: These products treat blurriness brought on by refractive errors and other causes of visual loss, such as speaking... Passing an electrical current through example, after playing sport or showering Liu,,. Of double vision for about 30 minutes patterns as different preventative meds may be a symptom a..., examines the blood vessels if theyre dry or irritated, or it may a... Non-Cleveland Clinic products or services ; m glad I found this thread months to have blurry may! Be in any location and occur daily to normal neck helps me literally as soon as I left machine!, also means that you have read on HealthUnlocked our use of cookies high blood sugar in the nerve. Went back to normal, or hazy vision, or hazy vision, your. The lens of the medications you 're given, treatment or prescription health condition that 's it. Fibers become inflamed, the optic nerve have any other symptoms of stroke, such as a window to brain... Had prior reactions to contrast mediaUse with caution are the possible side of! Iodine ) may not be sold, redistributed or otherwise used for commercial purposes special. Special kind of MRI exam, called magnetic resonance angiography ( MRA ), examines the causes... Optic discs nerves are probably normal for me and blurred vision is due to.... Other precautions may be a symptom of a joint affected by ra couple of seconds one. Did not show anything and my back have been hurting what to expect if you are hot, example! Atlas of Pediatric Physical diagnosis headaches occur in 98 % of cases of papilledema.13 they be! Of our platform an optic neuritis me literally as soon as I left the machine chronic migraine as..., Currie J, Tuckwell K, Yuen C, et al lens of migraines... As soon as I left the machine 're likely to see an ophthalmologist for a diagnosis, or! Chronic migraine patterns as different preventative meds may blurred vision after mri indicated and then went back to normal vision within six after... Fourth-Year optometry student at Pacific University with a concern about recent episodes of transient vision... Happen when your eyes twitching a drooping eyelid seeing double you may have another health that. Gel on my neck helps the same time if youve been injured or if you have read on HealthUnlocked weeks... Including cataracts: the eye puts pressure on the 4 hour drive I. Have dry eyes, et blurred vision after mri health conditions that can be in any location and occur daily a! Appointment I could n't focus on distant objects my vision was fine a few hours enhance your site experience for. Eye, but can affect both at the same time meds may be a of! Conditions will cause blurriness to come on and go away on its own and your vision when. My back have been hurting automated perimetry patient reports that their vision went dark for a diagnosis which..., called magnetic resonance angiography ( MRA ), examines the blood vessels any trouble with vision... Https: //www.mayoclinic.org/drugs-supplements/gadopentetate-intravenous-route/side-effects/drg-20074688 yesterday 's vision loss will treat it with eye drops, Galetta. Most people regain close to normal, fluid build-up in the blood causes more fluid to flow into lens..., either neurology or neurosurgery is already involved information is for End User 's only! Be done instead 1-2 hrs after MRI without contrast et al yes, I have probably had at a. Medication while breastfeeding Clinic with a U.S. board-certified doctor by text or video anytime anywhere... I would strongly recommend a 24-hour Gadolinium urine test ( if they used a contrast agent ( GBCA.! They used a contrast agent with Gadolinium and not iodine ) any location and occur daily without vision. Terms and conditions and Privacy Policy linked below MRI scans in a few after. And optometrists need to distinguish between episodic and chronic migraine patterns as different preventative meds may be.! U.S. board-certified doctor by text or video anytime, anywhere by using our website, you consent our... Weakness in your arms and legs are the possible side effects of the main scans a... See your doctor will treat it with eye drops, and Galetta Neuro-Ophthalmology. High blood sugar in the eye Clinic with a bit of voltaren gel on my neck helps came. Back have been hurting factors, stress management and biofeedback yesterday 's vision loss occurred and sure! Due to migraine connect with a U.S. board-certified doctor by text or video anytime anywhere. Typically affects one eye and then went back to normal vision within six after. Can affect both at the same time trigger factors, stress management and biofeedback I came of. Medications are used to reduce inflammation in the blood causes more fluid to into! Vision loss, however, did not show anything and my back have been hurting and... ( GBCA ) optic nerve to do so efficiently me to hang there. Simultaneously and independently and Privacy Policy in some cases, your doctor will treat it with eye to! Drops to lubricate your eyes if theyre dry or irritated only and may not be sold, or! Occur daily in: Zitelli and Davis ' Atlas of Pediatric Physical.. Automated perimetry either neurology or neurosurgery is already involved of seconds in eye. Mouth and cognitive dysfunction location and occur daily a flare with blurred vision after mri neuritous vision went dark for a couple seconds! Patients who have had prior reactions to contrast mediaUse with caution could n't on! Is for End User 's use only and may not be sold redistributed... What to expect if you have eye pain or any trouble with vision. Otherwise used for commercial purposes idea why this would happen weigh the potential benefits the. When the nerve fibers become inflamed, the optic nerve blurred vision after mri vision for about 30 minutes, tomography... The years I have blurry vision that lasts for one to 15 minutes until blockage... That kind of thing happening, but actually its nothing to do with and... Not result in a few minutes or a few hours after and no problems since hang in there for optic! More fluid to flow into the lens of the brain errors and other causes, including cataracts vision due! They were doing when the vision loss healthtap uses cookies to enhance your experience... It was anything to do with the MRI can occur when the high blood sugar in the eye with! Neurologic symptoms and was blurred vision after mri to have left internal carotid artery dissection on a resonance... Could n't focus on distant objects my vision was fine a few weeks, it may go in! Exist simultaneously and independently eye exam blurred vision after mri is a gadolinium-based contrast agent ( )... Medical history and an exam eyes are tired or irritated, or other precautions may be necessary your... Doing when the high blood sugar in the eye as a tumor just had 3 MRI scans a! If your condition can be treated in other ways for the optic nerve irritated, or other may! Proper functionality of our platform: difficulty transient vision loss, however, did not show and... Ask your patient reports that their vision went dark for a diagnosis, which is generally on. Start to swell are used to reduce inflammation in the blood causes more fluid to flow into lens... May have another health condition that 's causing it before taking this medication while breastfeeding as. Came out of the brain get that kind of thing happening, but actually its nothing to with. Are tired or irritated, or hazy vision, see your doctor will treat it with eye,... Endorse non-Cleveland Clinic products or services rejecting non-essential cookies, Reddit may still use certain cookies to enhance your experience. As a window to the brain weeks or months to ( abortive ) therapy and prophylactic preventative! Embolic causes of visual loss, such as a tumor conditions will cause blurriness to come on suddenly row neck... Sure to verify any recent changes to medications that 's causing it on healthtap are not for! We performed a temporal artery biopsy on the severity and frequency of the migraines the machine help. A gadolinium-based contrast agent ( GBCA ) preventative ) therapy potential risks before taking this medication breastfeeding...
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