This Is MS Multiple Sclerosis Community: Knowledge & Support

Hi Kleiner--
Jeff used to wake up gasping for air a few times every night. He'd also thrash and spasm a lot... his doctor thought it was sleep apnea, and he had a sleep test scheduled. We ended up canceling it before he had angioplasty at Stanford. Since the angioplasty, he no longer wakes up gasping, no snoring, no spasms. The change has been remarkable. The only change was the angioplasty and opened jugular veins. We now think that the gasping was his body's way of waking him, so he would sit up and breath.

Here's an interesting study. Doctors here call MS sleep apnea "central sleep apnea" ...meaning it is linked to lesions in the brain, not obstructions in the throat.


http://nnr.sagepub.com/content/3/3/133.abstract

I'm sure "central apnea" is what the docs would have called Jeff's apnea...but it resolved the day after his angioplasty. Does this mean the lesions in his brain healed overnight? No. It means he was receiving oxygen.
cheer

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Husband dx RRMS 3/07
dx dual jugular vein stenosis (CCSVI) 4/09
dual stents placed 5/09
CCSVI in MS

Hmm. But it can't be that binary a matter. My feet turned purple standing up when awake, now (jugulars opened) they don't. Likewise cogfog. Improvement often seems to be immediate and not posture-dependent.
-d

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dx rrms august 2009 (dx CFS spring 1988) off avonex after 3 months
treated katowice 24-25 march 2010 - best thing that ever happened - check tracking thread

There's a particular sign in the Zamboni ultrasound that counts as an indicator of CCSVI. It's when the jugular's CSA is bigger when you're standing then when you're lying down. I don't get why. But it would be something that if the jugulars were cleared improvements would happen when standing as well.

My take on that one is that there is some flow diverted from the vertebrals when you are upright. It should not be there. I don't know what causes them to collapse in the upright position, but I hears it's pretty dramatic when you are watching it on Doppler.

This sounds like the negative CSA thing. It will go negative if the cross-sectional area (CSA) is relatively smaller (prone minus upright is a negative number). Two things could be at fault: 1 the jugulars fail to grow larger when you lie down; 2 they fail to grow smaller when standing up. It's still relative: Prone is smaller: neg CSA. I think the prone CSA is normally be the larger of the two. P > U is normal. U > P is abnormal.

Sounds like what is happening is when you lie down the flow is normally off-loaded from the vertebrals (maybe because there is no more gravity to move it to or through them). But if there is a blockage, perhaps they fail to inflate when you lie down. So then, blood will be driven by gravity when upright, and maybe goes through collateral veins when you lie down. When upright, there will still be a blockage, so maybe the gravity that normally closes them can't do it because of something stopping it. So an obstruction might actually be keeping them more open when you are upright. I can't remember but I would imagine this is a measurement at the widest part of the vein. I think what can happen is the collapse and disuse when you are upright doesn't happen because the overall capacity is too low (stenosis in vertebrals?) and there is always enough upstream pressure to keep the jugulars patent.

I don't know. I would like to know more about that switchover, the mechanics of it normally. What parts of the brain are involved...

Isn't hemodynamics fun?

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"Try - Just A Little Bit Harder" - Janis Joplin
CCSVI procedure Albany Aug 2010
'_MS' is over - if you want it
Patients sans/without patience