Transcranial Doppler

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Positivenelly
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Transcranial Doppler

Post by Positivenelly »

Did anyone have a trans cranial Doppler done in regard to MS? I went to the neurologist the other day and she did a trans cranial Doppler (results were "a little stiff"?) and now I have a brain MRI, a sleep study and a carotid ultra sound scheduled. I am currently undiagnosed.

Thanks for any information. I'm not sure if this is related to MS or a different condition.
centenarian100
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Re: Transcranial Doppler

Post by centenarian100 »

Generally, TCD is not a standard test for multiple sclerosis

TCD results report velocities (elevated velocities imply vessel stenosis) and embolization, not "stiffness," so I am not sure what your neurologist is considering. S/he is probably considering something other than MS given the sleep study/carotid ultrasound.

Best of luck

-C
Positivenelly
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Re: Transcranial Doppler

Post by Positivenelly »

Thanks for your response.

(Another doc sent me to the neurologist for "possible MS")

I led with the chief complaint of fatigue, so she immediate latched to the idea of sleep apnea, which she wants to rule out, hence the sleep study. I don't snore (well, when my sinuses are blocked I do snore) but since Im so tired all the time, I agreed to do the sleep study. What the heck. Maybe it will solve something.

I'm not sure why she did the Doppler, but since there apparently was some type of finding, now I'm getting the carotid ultrasound.

The brain MRI is to rule MS in or out and I'm getting that in two weeks.

Ill be around reading... To be honest, if it is MS ill be so relieved. I mean, finally ill know what the issue is. I'm so sick of getting jerked around by doctors; at least this one took me seriously.

Thanks again.
centenarian100
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Re: Transcranial Doppler

Post by centenarian100 »

Not to dismiss your symptoms, but it is much more favorable to have unexplained symptoms than to have multiple sclerosis. Multiple sclerosis can be quite serious. I pray for your sake that the MRI is normal.
Positivenelly
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Re: Transcranial Doppler

Post by Positivenelly »

Oh, I pray it is normal as well, but you can go ahead and assume I'm pretty bad off considering I'm getting these tests done in the first place.

As long as it is something I could possibly do something about, I'll be relieved with a diagnosis.

Such is my life right now...

Thanks again.
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cheerleader
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Re: Transcranial Doppler

Post by cheerleader »

Sounds like your doctor is looking at vascular issues which may be behind your problems. Transcranial doppler is part of the diagnostic protocol for CCSVI, or chronic cerebrospinal venous insufficiency, related to venous abnormalities affecting blood flow from the brain. The deep cerebral veins can be studied with this technology, and if there is reflux, it is an indication of a problem. The carotid artery test will look at your extracranial blood flow, or blood outside the brain, and how it is being delivered to your brain.
Here is a recent publication from the Journal of Interventional Radiology on the different tests for venous problems.
http://www.sciencedirect.com/science/ar ... 4314007465

Hope you get more answers-- hang in there, and keep us posted.
cheer
Husband dx RRMS 3/07
dx dual jugular vein stenosis (CCSVI) 4/09
http://ccsviinms.blogspot.com
Positivenelly
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Re: Transcranial Doppler

Post by Positivenelly »

Ah found this:

"Functional transcranial Doppler should be more entertained in investigating cognitive dysfunction in multiple sclerosis patients. It may offer a future promising tool for diagnosing and following up treatment and rehabilitation effects."

http://www.jofamericanscience.org/journ ... 74_178.pdf

So maybe it is something new: a non invasive, quick evaluation for MS cognitive issues?
Positivenelly
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Re: Transcranial Doppler

Post by Positivenelly »

cheerleader wrote:Sounds like your doctor is looking at vascular issues which may be behind your problems. Transcranial doppler is part of the diagnostic protocol for CCSVI, or chronic cerebrospinal venous insufficiency, related to venous abnormalities affecting blood flow from the brain. The deep cerebral veins can be studied with this technology, and if there is reflux, it is an indication of a problem. The carotid artery test will look at your extracranial blood flow, or blood outside the brain, and how it is being delivered to your brain.
Here is a recent publication from the Journal of Interventional Radiology on the different tests for venous problems.
http://www.sciencedirect.com/science/ar ... 4314007465

Hope you get more answers-- hang in there, and keep us posted.
cheer

Thanks. May I ask why you had stents in your jugular?

Edited: I'm going to check out your blog, thanks.
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cheerleader
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Re: Transcranial Doppler

Post by cheerleader »

Positivenelly wrote: Thanks. May I ask why you had stents in your jugular?
Sure.
My husband had stents placed in his jugular veins and dural sinus at Stanford University in 2009, because all these areas were highly stenotic (closed >90%) and he had cognitive fog, heat intolerance and fatigue, which resolved upon treatment. He's almost 6 yrs. past treatment with a reversal of gray matter atrophy. Still jogging, biking, working full days. He's out in 90 deg. southern CA. heat today, working on my raised bed garden boxes in the backyard.
The procedure was helpful for him, but not all patients had similar success. He was the first treated, and published here:

Endovascular correction of cerebrovenous anomalies in multiple sclerosis: A retrospective review of an uncontrolled case series
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4164629/

Also, functional transcranial doppler (as used in the paper you linked) is measuring cerebral blood flow and perfusion during tasks.
http://www.ncbi.nlm.nih.gov/pubmed/17290143
Simple transcranial doppler testing does not involve tasks/word or number problems. It just looks at blood flow.
Would be interested to know which of these test you receive. Best to you!

cheer
Husband dx RRMS 3/07
dx dual jugular vein stenosis (CCSVI) 4/09
http://ccsviinms.blogspot.com
Positivenelly
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Re: Transcranial Doppler

Post by Positivenelly »

Update thus far:

Brain MRI showed a textbook normal brain (I mean thank god for that).

I had the consult with the sleep study doctor and she actually suspects Narcolepsy, which truly surprised me. (The neurologist suspected sleep apnea, which I don't think I have).

So it appears I do not have MS and have moved on to other issues. The carotid doppler is a few weeks away.

Thanks everyone! Take it easy....
Positivenelly
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Re: Transcranial Doppler

Post by Positivenelly »

One more update in case anyone is interested as this falls into the archives and someone searches:

The carotid ultrasound came out normal. My sleep study did not. Even though I am a woman with a small neck and no snoring, it turns out I have severe (they call it "significant") obstructive sleep apnea. At one point, I stopped breathing for nearly a minute and my oxygen saturation got down to 61%.

The narcolepsy study was cancelled since the apnea was so bad. So off I go into CPAP land. Without insulting anyone here, I'm sure you all can appreciate my relief that this is something fixable with a night time machine.

My very best to you all, and happy holidays.
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Re: Transcranial Doppler

Post by NHE »

Positivenelly wrote:One more update in case anyone is interested as this falls into the archives and someone searches:

The carotid ultrasound came out normal. My sleep study did not. Even though I am a woman with a small neck and no snoring, it turns out I have severe (they call it "significant") obstructive sleep apnea. At one point, I stopped breathing for nearly a minute and my oxygen saturation got down to 61%.

The narcolepsy study was cancelled since the apnea was so bad. So off I go into CPAP land. Without insulting anyone here, I'm sure you all can appreciate my relief that this is something fixable with a night time machine.
It's great that you were able to get your sleep apnea diagnosed. Untreated sleep apnea is strongly associated with dementia. As MS patients, we already have enough problems.

http://www.ncbi.nlm.nih.gov/pubmed/25070768

http://www.ncbi.nlm.nih.gov/pubmed/23400634
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cheerleader
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Re: Transcranial Doppler

Post by cheerleader »

Hey Positive!
Glad to hear it is something that can be addressed with cpap. Your brain needs that oxygen!
You are very, very fortunate.
Happy holidays to you, and here's to a better, refreshed New Year!
cheer
Husband dx RRMS 3/07
dx dual jugular vein stenosis (CCSVI) 4/09
http://ccsviinms.blogspot.com
Positivenelly
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Re: Transcranial Doppler

Post by Positivenelly »

Thanks guys-- thanks for the studies too NHE. My apnea is under control now but my low oxygen saturations are not, so I'm troubleshooting with the doc to get this right.

Good luck to you guys too! I hope 2015 is a good year for you and here's hoping for some new therapy breakthroughs for MS!

BTW, a European study in 2012 (I think) stated that up to 50% of women (of all women!) have sleep apnea, so if you have MS and are still having daytime sleepiness, I suggest you consider whether you may also have obstructive sleep apnea.


Bye! :wave:
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