Multiple Sclerosis and Physical Trauma:
For over a century, patients and physicians have dealt with the phenomena that suggests that trauma may proceed the onset of MS or may aggravate ongoing MS. Because of the variability of the course of MS, there is some controversy regarding the causation between physical trauma and onset or aggravation of MS. However, more recent studies have shown that trauma to the head and neck does indeed bear a relationship to the aggravation of or creation of MS.
A 2001 article in the European Journal of Neurology (A. Chaudhuri and Behan). In the conclusion of the paper it is noted:
Like infection, which will trigger MS symptoms only in a portion of a patients [10% (McAlpine et al, 1965) - 48% (Sibley and Foley, 1965)], cervical cord hyperextension - hyperflexion injury is likely to unmask or worsen the natural course of MS in a sub group of affected patients with an underlying diathesis. This may be important because of the prevalence of asymptomatic ("silent") MS has been estimated to be about 25% of that diagnosed invivo (Engell, 1989). We make it clear that we do not propose physical trauma in any form causes MS per se. Physiologically, CNS - specific trauma produces focal reaches in the BBB [brain-blood barrier] and induces metabolic changes by activating the stress response. In addition, focal trauma also enhances the expression of nitric oxide synthase in the CNS microvasculature. In susceptible individuals, these effects might unleash critical changes in the level of pro-inflammatory cytokines and nitro oxide, this triggering MS symptoms ab initio or aggravating symptoms of pre-existing latent disease.
Dr. Charles Poser of Harvard Medical School has long been a proponent of the link between trauma and MS. As he notes in his enclosed paper entitled "Trauma to the Central Nervous System May Result in Formation or Enlargement of Multiple Sclerosis Plaques," "In some patients with MS certain types of trauma may act as a trigger at sometime for the appearance of new or recurrent symptoms. Only trauma affecting the head, neck or upper back, that is, to the brain and/or spine cord can be considered significant." (Published in the Archives of Neurology, July 2000). Dr. Poser goes on to talk about the effects of whiplash on the central nervous system and outlines the existing extensive medical research that back up the correlation.
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