DrSclafani answers some questions

[drsclafani]

That being said, i recently have had two patients with severe spasticity which I believed were clearly due to demyelinization. To my surprise some improvements occurred after venoplasty. I still cannot figure out why this occurs.

The improvements were immediately after venoplasty?

If you were correct in assessing that the spasticity as being due to demyelinization and yet we also know remyelinization does not occur between the start and end of angioplasty, then restoring the flow must be doing something to restore the function of the demyelinated neurons despite their continued state of demyelinization. (Assuming it is not placebo or an effect of medications such as fentanyl used during the procedure.)

Here we go, this ties into a question asked here two years ago:
http://www.thisisms.com/forum/chronic-c ... ml#p126508
and your two-years-ago response:
http://www.thisisms.com/forum/chronic-c ... ml#p126532

and a quote from the research linked in the first link

Conduction velocity, depressed by 26% with diabetes, was normalized by treatment. These observations support the hypothesis that hyperglycemia-induced blood flow reductions and resultant endoneurial hypoxia are important factors underlying nerve conduction deficits early in the development of diabetic neuropathy.

It could be that when an immediate improvement is seen in spasticity due to demyelinization, the immediate improvement is due to the relief of CNS nerve conduction deficits due to blood-flow reductions and resultant endoneurial hypoxia. This is assuming that the reduced perfusion seen in MS is due to outflow obstructions and that the treatment of outflow obstructions leads to improvement in cerebral perfusion, which would need to be proven.

yes cece
those are also good hypotheses for reductions in spasticity.
but patients should be realistic that the majority will not see gains in spasticity, at least in the short term

[drsclafani]

Hi NZer1:
I'm not comfortable with Facebook so I couldn't look up your articles. Sorry. The antibiotics issue isn't the point. ANYTHING my body finds toxic can impede the blood flow which in my case includes glutens and alcohol (That's why I probably fell apart when I moved to France, great bread, great wine, cuisine in general.)

On his thread dated April 3, 2012 Dr Sclafani wrote

"There are other malformations of veins that are well known. They include problems with the veins of the liver as they join the inferior vena cava. This well known entity is called Budd Chiari syndrome and results in major problems of the liver.

"The SPINAL CORD has an interesting venous drainage. There are small veins that exit the spinal cord and enter venous plexuses that surround the spine and vertebrae. (A venous plexus is a tangle of very small venous channels
and lakes. )These plexuses connect up and down the spine. Some then drain out into larger more defined veins. These veins can drain upward into the brain and then back down the venous sinues to the jugular vein. There are also veins that connect the cervical plexuses to the upper jugular vein itself. The cervical venous plexus also drains into the vertebral veins and they connect to the subclavian or innominate veins. lower down in the thoracic spine these plexuses drain into veins that connect to intercostal veins and hemiazygous and azygous veins. Lower down still there are veins that connect the vertebral veinous plexuses to lumbar veins, ascending lumbar veins, and the inferior vena cava and lots of other veins."
hol

These are questions for Dr. Sclafani.
1)It seems to me there are many more veins which can malfunction than the jugulars, vertebrals and azygous.. Would this account for the disappointing results for some patients after Angioplasty, that not all potential CCSVI pathologies can be discerned or treated?

I speak about that which i cannot see. Vertebral venous problems do not seem to be abnormal in those i have studied. brachiocephalic veins,. and the superior vena cava must be mentioned. Also renal vein ob struction can surely created increased flow through the hemiazygous and azygous veins. Abnormalities of these vein can affect symptom of CCSVI.

2) Is there a vein/brain/spine map, that is to say knowledge of which area of the CNS controls which bodily function and which veins link up to those areas? Probably not, but thought I would ask.

Yes there are clearly veins which drain various parts of the brain. However in the zamboni hypothesis and the schelling hypothesis brain and spinal injury need not to be related to the site of venous problems

3) Does a CCSVI blood reflux resemble a stroke in terms of brain damage and immune system reaction?
Thanks for your help. Vesta
MS Cure Enigmas.net

they do not seem to resemble each other at all.

[Cece]

That's great news mark. I think that your hypothesis is reasonable. Perhaps we really do not know how long improvement will take to manifest themselves

Yes there are clearly veins which drain various parts of the brain. However in the zamboni hypothesis and the schelling hypothesis brain and spinal injury need not to be related to the site of venous problems

yes cece
those are also good hypotheses for reductions in spasticity.
but patients should be realistic that the majority will not see gains in spasticity, at least in the short term

Hypotheses upon hypotheses.
Welcome back

[Cece]

Roll call? Who is still here?

[Algis]

I am; but just peeping and learning

[QueenMum]

Mum is here. Reading & learning like Algis. And very appreciative of every thought, question & answer posted.

[NZer1]

Present,

[Cece]

Roll call? Who is still here?

Cece
Algis
QueenMum
NZer1

[munchkin]

I am still here reading and I do have a question for Dr.Sclafani but must figure out the wording.

[the_r]

I'm reading. Just trying to keep a low profile is all.

[mazza]

Me too.

[jillMEnz]

me too!

[itsjustme]

here

[CureOrBust]

Present.

[Cece]

Roll call? Who is still here?

Cece
Algis
QueenMum
NZer1
munchkin
the_r
mazza
jillMEnz
itsjustme
CureOrBust