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I saw an episode of "Lie To Me" where they showed a reaction to Fear that I think involves that muscle. I don't know if simulating that would help, though, if you want it to be less prominent. Would stretches help build it up or weaken it? Maybe that's where we need the Botox.

There are other neck muscles but, yeah, the omohyoid muscle might be the one to botox.
It's been done for something called omohyoid muscle syndrome.
http://onlinelibrary.wiley.com/doi/10.1 ... ated=false
But the botox can affect swallowing so it could be risky in MS patients who may already have swallowing impairment.
Stretches should help lengthen the muscle, which would reduce how tight it is against the jugular vein?

Anything new about that issue here ? In Italy it happens very often to find problems with this muscle in patients that have re-stenosis at least 2 times . When I went to the doctor and he examed me he told me not to do another angioplasty because it will not work if I do not fix the muscle . I continue to not feel well and I am waiting my appointment with the doctor .

I have not heard anything new, unfortunately.

I would think external compression by a muscle would have a distinctive look on the catheter venogram images, so that your IR could tell you if you had this?

No cece, I had 2 angioplasties and the doctors did not tell me anything , but after the angioplasties I got worst , I had the test for the muscle in Italy and I am positive , I was wondering what happens in America about that issue. 2 weeks ago a study about it was presented at Bari http://www.ccsviitalia.org/7/post/2013/ ... bilia.html
I suffered a lot from ccsvi symptoms and now I have an answer . I am waiting to operate this muscle .

Wow, that's a great link. They've got images of two different types of compression. This is good too:

All surgeries were well tolerated and accepted with a good compliance by all patients. They have been affected by the resection of 16 muscles on the right and 14 left.

No major or minor complication was recorded during surgery. No problem at the level of surgical incisions that have healed without complications and with good aesthetic outcome.

As far as I know, there aren't any doctors in the US treating omohyoid muscle compression of the jugular vein. It's a physiological compression which means it changes based on which direction you move the muscle so it's not as clear-cut as treating stenoses that are constant and never change. It's also a surgical snipping of the muscle so there are potential risks. Dr. Sclafani has said in the past that he is waiting for evidence. Maybe what the Italian researchers are doing will begin to provide that evidence.

I have slow flow in my upper jugular due to external compression and for now I'm sitting that out and doing nothing about it, but I had good results after angioplasty so that's a very different situation, and I am able to wait until it's clear what needs to be done.

I hope you are right and this is the answer and that the surgery is a success.

Here are the additional tests that the researchers are doing, from aliki's link. First they do the standard CCSVI Doppler, then this.

a) test of the platysma - with the execution of this operation, in normal ranges cervical superficial and media are dragged from the muscle and vein dilates enormously. In 15% of patients observed previously subjected to PTA, the test does not cause any expansion of the jugular vein, the vessel appears motionless and look round. This framework is due to the fixity of the band and was subsequently confirmed intraoperatively.

b) test Omo-hyoid-sternocleidomastoid - asks the patient with shoulders down and chin up to rotate the head to the maximum counter-lateral to the point of observation. In control subjects normal in such a situation the sternocleidomastoid and omohyoid are stretched but turn away from the vein, which increases in size and flow, as the contralateral is compressed by the movement. Is considered pathological the case in which, already in basal conditions, the muscle complex completely compresses the vein throughout the course so as to not be detectable by ultrasound.

So the question is if these are accurate ways to diagnose a muscle issue and if the muscle issue is severe enough to have an effect that warrants treating or if it is a passing effect that does not warrant treating.

The authors have chosen to make only the ECD in view of the fact that it is in a sitting position that the real conflict is true veno-muscular. With the patient supine, the neck muscles did not load and therefore does not create dynamic compression

Ok the effects of this compression should be felt while upright but not while lying down, since it is not present when lying down.

In 2 patients, there were immediate improvements in visual acuity. That's a familiar CCSVI improvement that might suggest there is something to this. I don't know how much weight to put in the report of EDSS improvements or brightening of the face or improved alignment of the neck.

Dear Cece , I just read your answer .
The thing that I do not understand is how this compression could be natural ? If it was natural none could have benefits from this operation .The fact is that from what I have read and I still read from other patients that have done this surgery that is not harmful and is being done with topical anesthesia with no risks ,is that they are having improvements from 0,5 until 2 on their EDSS . I have discussed with people that have done it and they have told me that they feel better , much better .
I did not have any benefits from the angioplasty and for 2 years I was wondering why this happens to me? I was asking the doctors why? And I got answers like "your MS is very aggressive..." I do not have aggressive MS . I do not have relapses only I feel very bad with my ccsvi symptoms . Some months ago , an italian doctor examed me and told me " you have a proplem with your muscle" . That can explain my situation .. I do not know how the operation will help me , I have not done something about this problem yet but I would like to say to the people who suffer from the ccsvi problems after the angioplasty , who have many re-stenosis to think that maybe there is a muscle problem that none have found .