dlynn wrote:Dr. Sclafani,
on another thread, "Albany Researchers Cancel MS Clinical Trial", you mention "There are patients who have delayed onset of some improvements up to one year after treatment" Can this be the case also in treatment of NCS and PCS?
Interesting question. I must admit that my sample size of patients with NCS (nutcracker syndrome) and PCS (pelvic congestion syndrome is much much smaller than for strictly CCSVI. There are also differences in presentations as well. For example many patients with NCS and PCS have very different symptoms manifested by pelvic pain, pelvic floor weakness, and varicose veins, varicose veins, blood and protein in the urine and anemia. The myelopathy described in NCS by Alboutier and Leriche in the mid 1970s is probably a component of CCSVI since they described patients with spinal venous congestion caused by renal vein compression associated with other venous obstructions including the internal jugular veins, azygos system and iliac veins. Delayed improvements have been reported by Scholbach with medical treatment of NCS. My experience is mostly with patients with both ncs and ccsvi associated with MS. Some patients gradually improve many symptoms. It is impossible to determine in such cases if any particular vein treatment is more instrumental in benefits.
dlynn wrote: Have any of your CCSVi or NCS (20 yrs. or more dx) patients regained strength in their legs post procedure?
most definitely. But i think that a better predictor is the degree of disability rather than duration of MS. Severe spastic paralysis usually does not improve too much. However weakness and foot dragging can definitely improve.
dlynn wrote:What improvements do you typically see in patients with 20+yrs. since diagnosis?
thank you
the most common improvements are cognitive improvements, balance, vision, fatigue, memory, To less degree motor strength, improved gait, sensory deficits. Sometimes one improves, sometimes all. sometimes none...It all depends on the degree of neuronal death