This Is MS Multiple Sclerosis Knowledge & Support Community

Good morning Athens, What you are referring to is that there is no cartilage between the skull and C1 or C1 and C2. There are ligaments however. On the front and inside of the UC spine you have the apical ligament, alar ligament, transverse ligament, long ligament, capsular ligaments, cruciate ligament and tectorial membrane. On the backside you have membranes more than ligaments such as the atlantoaxial and atlantooccipital membranes and their accessory ligaments. Some anatomists also suggest that the small special upper cervical muscles act like check ligaments to limit the motion of the upper cervical spine and prevent it from migrating into and impinging the contents of the spinal canal.

This doesn't sound good. I mean lots of stuff may be traumatized in there indeed.
But ligaments and membranes shouldn't play an important role neurologically speaking right?
Please, say right...

Are there any blood vessels running through those membranes that may cause some type of CCSVI?
Please say no...

Ligaments are for joint stability. The don't affect the cord or nerves unless there is calcification and overgrowth and they invade nerve spaces. You also have good muscles which will compensate for any ligament damage.

The posterior blood supply routes to the brain called the vertebral arteries pass through the atlantooccipital membrane between the occiptut and C1 and is very much part of the problem in your case and many other MS cases. The vertebral arteries supply the motherboard of the brain. After they enter the skull two branches come off of it called the anterior and posterior spinal arteries that go back down through the foramen magnum again and supply blood to the front and back side of the cord. Injury to the upper cervical spine definitely affects blood flow to the brain and cord especially the cervical cord. It is probably one of the major causes of brain fog and dizziness for example.

In addition to the vertebral arteries you also have the vertebral veins that pass through the upper cervical spine and you have the subarachnoid space of the cord which contains cerebrospinal fluid.

You definitely have vascular problems but they can only get better by realigning the foramen magnum and spinal canal in the upper cervical spine and taking the pressure off the vertebral arteries, vertebral veins and susbarachnoid space .

So, i got ligaments covered since i can still hold my head straight.

About vertebral arteries and veins, if they were torn somewhere along the cervical spine, there should be hemorrhage and my MRIs don't show anything like that. So more likely you mean that there may be pressure upon them and by aligning the cord to its proper position the problem should be minimized.

uprightdoc wrote:taking the pressure off the vertebral arteries, vertebral veins and susbarachnoid space .

Could one fit the blood brain barrier breach in this situation? Don't forget that there were findings in my spinal tap.

uprightdoc wrote:the subarachnoid space of the cord which contains cerebrospinal fluid

Forgive the simplicity of my views but I am planning to take advantage of your VAST knowledge and your willing to share it with us. I promise i ll get better in this Dear Doctor Flanagan.

Thank you very much.

Yes. They definitely get compressed, which can result in chronic ischemia or decreased blood flow. Chronic ischemia is a suspect in demyelination.

The permeability of blood brain barrier is affected by many things such as hyperventilation and changing position from lying down to standing up. Certain drugs and toxins also affect the permeability of the blood brain barrier. Trauma can likewise cause temporary breaches in the BBB. In my opinion, however, breaching of the blood brain barrier is not the major cause of MS. The hypothesis fails to explain many of the unusual aspects and demographics of MS.

uprightdoc wrote:In my opinion, however, breaching of the blood brain barrier is not the major cause of MS. The hypothesis fails to explain many of the unusual aspects and demographics of MS.

This is the last you hear from me for some time i promise. I don't wont to be a pain.
I don't think they claim that the breach is what causes MS. They use the findings more as an indication to back up the diagnosis. In my humble opinion this is probably correct since most of us are positive for bands and proteins while healthy people are not. And as you said trauma can cause only TEMPORARY breaches in the BBB, something that doesn't consist with the fact that in MS patients this is chronic.

In your view, would it be logic to assume that venous and arterial insufficiency may lead to the breach in some cases? Arteries are known for their endurance it's hard for me to imagine that any kind of substance would go through their walls and make it into the CNS.
I really don't have a clue about Zamboni's view on this.

It is not a problem. I am sitting here working on my new website and need a break.
I suppose compression of the arteries and veins could indirectly lead to breach of the BBB due to ischemic or waste by-products but not likely. Breaching the BBB brings things from systemic circulation into the hermetically sealed brain. The oligoclonal bands and proteins seen in CSF exams do not come from outside the BBB. They come from the brain and cord, which are "inside" the BBB.
The antigenic theory for example, suggests that certain agents from systemic circulation outside the BBB, such as from foods, infections and toxins, can breach the BBB and do their damage. If that were the case though, why are they so selective about the areas they attack. Why did they just attack your upper cervical cord precisely where you snapped your neck. Your myelin wasn't attacked by bugs. It was severely stretched and snapped. I will be covering Schelling's theory of myelin destruction in my next post. I will discuss back jets and shear forces that act on myelin. It makes far more sense.

Dr. Flanagan, thank you so much for all that you have contributed to this site since you’ve joined. I have never considered the fact that I could have anything other than MS….that is until now. When I read MS-Hope’s story, I could relate to it. I tried to review all the information you’ve provided on the site so I wouldn’t duplicate anything, but the brain fog and sometimes lack of comprehension has made it difficult.
I guess I’ll just outline my situation and see if you have any input. I’ve had symptoms for a very long time, 30-odd years. I had my first bout of nystagmus when I was 20, treated with steroids, but never told by the ophthalmologist he suspected MS. Had various symptoms for the next eight years until my first child was born. Six months later, the right side of my body went numb, could stick pins in me, no feeling. I also had nystagmus again, treated with steroids, told it was probably MS, nothing could be done, go home and live with it. I also have bad posture, and I just considered it a family thing. My grandfather, mother and two of my uncles all had the same rounded shoulder posture problems. My grandfather had a stroke, one uncle had Alzheimer’s disease and my mother had whatever I have, I believe. I also have low blood pressure and would never associate it with any of this until I found this site.
I have no x-rays, just copies of MRI reports.
My symptoms are fatigue, lethargy, weakness, trouble writing, vision problems, cog fog, memory, concentration, lost organizational ability, numbness, tingling, burning and I’m sure more that I’ve forgotten.
I’m on two lists for the Liberation Treatment, so I have time to explore other things. The only thing I ever associated numbness and tingling with is MS. In your opinion, is it possible my symptoms are related to posture or something else?
I didn’t read until today that you’re retired and live near Albany. I would have liked to book a consultation with you. It would be well worth the drive if you could help me feel better.
I also realize I’m one of the lucky ones. I have no outward symptoms, but there’s a lot going on in the brain. I just want to feel better.
Thank you again, Dr. Flanagan. I’m sorry this is so long-winded.

NZer1 wrote:Thanks Dr. for your latest;
http://uprightdoctor.wordpress.com/2010 ... s-lesions/
Pressure and Shear Stress in MS Lesions
Posted on October 7, 2010 by uprightdoctor

Thank you for this.
Looking forward to your next post Dear Dr Flanagan.

Thank you Costumenational and NZer1. I will cover shear foreces in the next post.

Hello Kathryn, Like MS Hope you have an interesting family health history. There is obviously a genetic connection. Among other things we inherit structural designs of the skull and spine that can have a profound affect on the health of the brain and cord. Fernando inherited a mild scoliosis and CurIous inherited a mild scoliosis and a cervical kyphosis. You have rounded shoulders running in the family as per your grandfather, mother and two uncles. You may likewise have cervical kyphosis similar to CurIous or you may have a Gibbus deformity, which is an exagerrated thoracic kyphotic curve. In either case curves can affect circulatory routes and deform critical bone and soft tissue neurovascular tunnels.

There is no question in my mind that there are circulatory problems going on in the family. Your primary mental symptoms suggest poor brain circulations and you have low BP. The total numbness on one side after childbirth almost sounds similar to mini stroke and your grandfather had a stoke. I would like to know what kind of stroke and where. What did it affect. Was it temporary or did it cause permanent disability. Your uncle had AD. What type. Was it the Binswanger's multi infarct dementia type? The numbness, tingling and burning you feel needs further explanation and investigation. Do you have any abnormal neurological test findings?

You need a really thorough case history and system review. You also need basic x-rays of your spine. If there is even a hit of scoliosis I prefer 14x36 full spine AP x-ray similar to Fernando's to get the big picture. I would love to see you MRI reports. Did they find anything. Did they do MR angiograms? There is something more going on here than meets the eye.

Dr. Flanagan,
Thanks for your time and effort on this forum.
I have not had a diagnosis but have had 3 flare ups over a 30 year period. The first was nystagmus (like the person posting before me) which only lasted a couple of days and then gone. Nothing for the next 12 years and then had alot of wierd nerve things, tingling, numbing, things getting numb quickly with a little pressure then going back to normal with movement, balance issues, eye problems with things moving quickly-couldn't follow, eye pain, tinnitus, loads of nerve or muscle twitching, many things. Over the next year things slowly resolved then over the following 16 years actually began thinking "maybe I don't have ms afterall". Then last year slowly alot of the symptoms from my second flare up returned and are still with me. I have had several mri's and loads of blood work. I don't know if this falls in your area of expertise or not but my question for you is in regards to a very wierd symptom I have. (my notes say I had this last time also)
When I wake up at night depending on the area I have been laying on, parts of my scalp and face are numb. The biggest thing I get is the right side of my face is numb and the right eye doesn't want to open and after a half a minute to a minute it will open. When I lay on my left side of face I start to feel like someone if pressing on my right side of face. If I lay on the back of my head I will start feeling as if someone is pressing on my forehead. I woke up the other night and sat up and couldn't feel the back of my head when I touched it. (yuck) Lots of wierd feelings like the signals are all out of whack. If I bend my head back as if leaning forward to look in a mirror, I start feeling the scalp tighten, again as if someone is pressing against it. I only have these odd sensations during a flare up.
I had surgery right before my first flare up and have been told by many Dr's except my gp that it shouldn't have anything to do with my symptoms. It was a sympathectomy done in the upper thoracic region for the sweat gland nerves.
Oh, I also have had the liberation procedure in Bulgaria and was found with severe stenosis. They did ballooning only. I have re-stenosed and am debating on what the next step should be. My symptoms are fairly mild but the balance issue can be frustrating.
I appreciate your opinion on this.
Thanks,
Kathy

uprightdoc wrote:Hello Fernando, Just out of curiosity, what type of doctor took the 14x36 x-ray and put in the heel lift. If I were treating you I would do SOT to balance the top and bottom of the spine. You already had success with the heel lift. The only chiropractors I found in Argentina so far however are Dr. Roxanna Pussetto in Santa Fe (03465 470542). The other is in Cordoba. Her name is Dr. Shirley Eichinger (0353 15 400403). Let me know if they are reasonably close. If not, maybe they know someone closer to you. I don't know their experience but they do knee chest upper cervical. Your curves complicate things a little bit but they are both equiped with x-ray units and should be able to handle it.

Thank you very much Doctor!

I will contact them. They are a little bit too far but it won't be a big problem.

My doctor is a very experienced man, a generalist doctor (we call it here a clínico) with a sharp, curious and young mind in the body of an 87 years old. He is the doctor of the user "gauchito" and through this site (God bless TIMS) I was able to contact gauchito who in time introduced me to him.

Thanks again dear Doctor.

Fernando

I have just realized that there is a whole array of chiropractors here in Argentina. Googled the names you gave me and all of this just popped up.

http://www.quiropraxia.org.ar/index.php ... res/search