Orthostatic intolerance ? MS symtpom?

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Postby sou » Thu Jan 27, 2011 6:31 am

Hemodynamic imbalance in the brain. Of course demyelination can't cause such a symptom but venous insufficiency could. It is quite common in MS, you know. Almost everyone has it, but you must not fix it. You will go directly to hell if you do!
Shortest joke: "We may not be able to cure MS but we can manage its symptoms."
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Postby gibbledygook » Thu Jan 27, 2011 11:01 am

I also have this and it developed when I was pregnant after I had stents placed in the jugulars at C1. I still suspect a blocked vein is likely contributing to this but who knows! I know that orthostatic intolerance is often simply a low blood pressure problem and I certainly have that. Do you have low blood pressure generally? If so it might contribute to cerebral hypoperfusion as per the pubmed article below:

J Hypertens. 2010 Jul;28(7):1498-505.

Blood pressure, cerebral blood flow, and brain volumes. The SMART-MR study.
Muller M, van der Graaf Y, Visseren FL, Vlek AL, Mali WP, Geerlings MI; SMART Study Group.

Collaborators (9)Algra A, Doevendans PA, van der Graaf Y, Grobbee DE, Rutten GE, Kappelle LJ, Mali WP, Moll FL, Visseren FL.
Department of Internal Medicine, VU University Medical Center Amsterdam, The Netherlands.

Comment in:

J Hypertens. 2010 Jul;28(7):1380-1.

Abstract
BACKGROUND: Low blood pressure (BP) has been related to increased risk of brain atrophy. As brain hypoperfusion might be a marker for impaired cerebral autoregulation, the risk of brain atrophy may be especially increased if BP is low in combination with brain hypoperfusion. We examined whether low BP was associated with brain atrophy and whether this association was stronger in patients with lower parenchymal cerebral blood flow (CBF), as an indicator of brain perfusion.

METHODS: Within the Second Manifestations of ARTerial disease-Magnetic Resonance study, a cohort study among 1309 patients with atherosclerotic disease, cross-sectional analyses were performed in 965 patients (mean age 58 +/- 10 years) with available BP and CBF measures. Parenchymal CBF was measured with magnetic resonance angiography and was expressed per 100 ml brain volume. Brain segmentation was used to quantify cortical gray matter volume and ventricular volume (% of intracranial volume).

RESULTS: Linear regression analyses, adjusted for age, sex, and vascular risk factors showed that the association of systolic BP and pulse pressure, but not diastolic BP, with cortical gray matter volume was modified by parenchymal CBF (P interaction <0.05). In patients with lower parenchymal CBF, but not in those with high parenchymal CBF, lower systolic BP and pulse pressure (per SD decrease) were associated with reduced cortical gray matter volume: beta (95% confidence interval) -0.29% (-0.63; 0.00) and -0.34% (-0.69; -0.01).

CONCLUSION: Our findings suggest that lower BP by itself is not sufficient to induce brain atrophy; however, lower SBP and lower pulse pressure in combination with lower parenchymal CBF increased the risk for cortical atrophy.

PMID: 20453669 [PubMed - indexed for MEDLINE]
3 years antibiotics, 06/09 bilateral jug stents at C1, 05/11 ballooning of both jug valves, 07/12 stenting of renal vein, azygos & jug valve ballooning,
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Postby cheerleader » Thu Jan 27, 2011 7:42 pm

hi Shinbet--
I've been doing a bit of research on this, since delayed bloodflow to the brain when standing and dizziness is a common MS problem, but as sou said, it may not be due to lesion location, but more likely, vascular issues. Go to www.ccsvi.org if you're not familiar with the recent gains in research regarding MS and the vascular system.

One of the areas I started looking into was hypovolemia, or low blood volume. I began studying this because of the high restenosis rates in CCSVI angioplasty, jugular collapse syndrome, and the fact that Dr. Dake kept insisting that my husband Jeff make sure he was hydrating. Hypovolemia occurs in people who are not hydrated enough or inactive. It happens in the elderly, and the chronically ill. It also happens in those who lose weight quickly. (been thinking about this for you too, Gibbs.) And hypovolemia is a cause of orthostatic hypotension. Here's a whole thread on hypovolemia...
http://www.thisisms.com/ftopic-15073-0- ... rasc-.html

One thing to look at is how much H2O you drink each day. Jeff's upped his liquid intake and it's helped keep blood flowing and all system's go. He also stays very active. Try it, it might help....hope you feel better.

Here's a handy calculator I found to figure daily liquid requirements:
http://nutrition.about.com/library/blwa ... ulator.htm
best,
cheer
Husband dx RRMS 3/07
dx dual jugular vein stenosis (CCSVI) 4/09
http://ccsviinms.blogspot.com
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Postby gibbledygook » Fri Jan 28, 2011 4:12 am

Good point Cheereo. I didn't put ANY weight on the during the pregnancy and am pretty damned scrawny. Must drink more. And not red wine! Nor caffeine nor cacao!!! Would help with the bowel as well, I'm sure.
3 years antibiotics, 06/09 bilateral jug stents at C1, 05/11 ballooning of both jug valves, 07/12 stenting of renal vein, azygos & jug valve ballooning,
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