CCSVI and CCVBP

[mystery1980]

Thank you for your answer Dr. Flanagan,

I have to translate your text, but the hernia is at level T4/T5 so thoracic.
And so if I understand it right, there is no connection between syringomyelia and MS?

Kind regards

[uprightdoc]

You are welcome Mystery.

The T4/5 disc hernia is an unusual location. The syringomyelia may be related to the T4/5 disc hernia. Is the syrinx above or beneath the level of the T4/5 disc hernia?

I do believe that there is most definitely a connection between the syringomyelia and your current condition. According to what you have described so far, you do not have definite MS. You probably do not have any lesions in the brain.

It is important to check the brain scan for a possible Chiari malformation or a pressure cone. It is much better to have the scan done in the vertical (upright) position to check for Chiari. A cervical MRI scan will show if you have malformations or misalignments in the craniocervical junction (upper cervical spine). It will also show if you have spondylosis or stenosis in the lower spine such as the disc hernia at T4/5. It is better to do the cervical MRI in the vertical (upright) position.

Have you had any trauma such as sports, car accidents, falls, fracturs etc. ?

[uprightdoc]

There is nothing yet Robert but there will be soon. It will then take some time after that for neurosurgeons to contemplate the theory and carefully consider the clinical implications. The good new is that they have already developed some fairly effective procedures. The challenge is knowing when to apply those procedure and to which specific cases. Many of the answers will come from MRI and Cine flow studies, especially upright MRI, which is rapidly improving.

[NZer1]

"Published on 9 Sep 2014
Dr. Mike and his wife, Jane, travel to New Zealand Chiropractic College for an Upper Cervical Specific conference for doctors and students."

[Robnl]

Hi doc,

Legmuscles MRC scale 3 (quadriceps/feetreflexes/extensoren).

Armmuscles MRC scale 4+ / 5 (biceps/triceps)

Hand en vingers MRC scale 4-

[uprightdoc]

Thanks Robert. It will be interesting to see your MRI scans.

[uprightdoc]

...The comment below is an interesting case of possible MS or myasthenia gravis that was posted on my website. In brief, what this person has is cerebellar tonsilar ectopia/CTE/Chiari malformation in the craniocervical junction along with with kyphoscoliosis, spondylosis (degeneration) and stenosis in the lower spine. Chiari malformations are associated with scoliosis and tethered (short) spinal cords. Chiari malformations, scoliosis and tethered cords affect females more than males. They are developmental anomalies. CTE, spondylosis and stenosis affect craniospinal hydrodynamics. Among other things, faulty craniospinal hydrodynamics can cause diplopia and nystagmus...


"Hello Dr. Flanagan ... My name is Gina and I live in South Florida. I want to start out by saying that I have never been in a car accident, played sports, or participated in gymnastics.

When I was 30 years old I was diagnosed with scoliosis of the spine and Pars Interarticularis Defect. My orthopedic doctor did not seem concerned about either one at the time. I continued to live with back pain for the next eight years. I suffered a lot during this time, as I was trying to be a good mother and wife and loyal employee. When I was 38 years old I went for my first lumbar spine MRI. I could no longer lift my own legs. My husband would lift my legs up over the edge of the tub so I could soak in a hot bath. The MRI revealed that there was a lot going on. I had a Grade 1 Spondylolisthesis, which was due in part to a bilateral fracture at the L5-S1 level. The stress fracture on the right side did not heal well, causing displacement of the exiting right L5 nerve root. I was eventually sent to Health South Hospital where I underwent a number of epidural injections and other procedures, all of which I had to go under anesthesia for.

It was two years later when I woke up to, probably the worst pain I have ever felt, only this time it was in my neck. Five weeks later, still dealing with neck stiffness and pain, I went for an X-ray. I was diagnosed with Reversal of the Cervical Lordosis. I was suffering from something that people usually get after they have been in a car accident ... Whiplash.

Over the next four years, all while I am dealing with horrible headaches, muscle spasms, etc. I went for 4 cervical spine MRI's & 2 more lumbar spine MRI's. The first cervical MRI showed disc bulging and disc herniation from C3 down to C7. And I just recently noticed that the report mentioned a "Mild Cerebellar Tonsillar Ectopia". This was NEVER mentioned. My Scoliosis was getting worse, which I knew because I could feel it getting worse (thoracolumbar dextroscoliosis).

Ok ... so this is where I am at today. It's pretty scary for me and I find myself crying every day because I don't know how I am going to get through this life alone. My job of 15 years is gone. They eliminated my position. My husband of 23 years divorced me and I still don't know why. I live alone, unemployed, almost out of money, and as of January 1st I no longer have health insurance. I've had many new problems with my bones and joints (right knee & right wrist). I went for new MRI's late last year. My Scoliosis is now categorized as "severe" (more issues noted in relation to my lumbar spine). My neck is so bad that I really shouldn't be driving anymore. It was noted again, "Loss of the normal lordotic curvature, grade 1 Anterolisthesis, 3 herniated discs result now in anterior indention of the spinal cord, moderate to severe spinal stenosis with AP dimension of 0.9 cm for one and two with AP dimensions of 0.8 cm. and the list goes on. The lumbar spine showing facet arthropathy throughout lumbar spine, anterior osteophytes throughout lumbar spine (and there is so much more).

I am sorry that this is so long, but it's hard to explain ... So this is the problem that I am faced with today. This past November, I started to experience double vision (binocular diplopia). I also have rapid eye movements. I think that I am blacking out every night while typing on the computer and wide awake?? My body jerks violently (computer has been thrown off my lap a few times). I NEVER remember closing my eyes and when I try to remember right before it happens, I can't. It's happened several times while I have been typing this to you. I ended up at the Neuro Ophthalmologist who was able to see my left eye jumping, while I followed his pen from left to right. Many more tests were done, but all seemed to be fine, except for the left eye jumping.

The doctor sent me for a Brain MRI. The doctor feels that I may have MS, but the MRI came back clean. The one thing that showed up was Congenital Cerebellar Tonsillar Ectopia - Tonsils extending 4 mm below the posterior lip of the foramen.

I don't understand why my new doctor (Neurologist) is stuck on Myasthenia Gravis and the other doctor (Neuro Ophthalmologist) is leaning towards MS. Both doctors totally blew off the issue I am having with the brain. My symptoms are in line with everything that you talk about?? My eyesight, in the last week has worsened and the double vision is also getting worse. I guess it really doesn't matter because I can't have any tests done or even go to the Neurologist because I no longer have health insurance and I don't have any money. It's fine though because I wanted to share my story with you. There is so much more than what I was able to include. I do want to add something that has to do with my handwriting. Handwriting has gotten very difficult. My handwriting is now very messy at times, my letters are small and I leave out entire words from sentences? This bothers me a lot.

Thank you for allowing me the space to tell my story. I am going to be 51 years old next month and I've literally had my entire life pulled out from underneath me. If only I had my husband to help me through this. I am afraid that I won't be able to do this on my own."

[Robnl]

Hi Doc,

Maybe i read something interesting: I read that problems with C7 could led to Croup. i had Croup....when i was young, between age of 2 and 5. Whern i was 5 my parents found me in a kind of seizure in bed...10 days in hospital...they suspected epilepsy....but they wee wrong.
My mother thinks i was a final Croup thing...

[uprightdoc]

Hi Robert,

You probably read the connection between croup and C7 on a chiropractic website that referred to the old Meric Chart system which is outdated nonsense. The seizure was probably caused by the infection, inflammation and fever.

[Robnl]

OK, clear...thx

[Robnl]

http://www.ncbi.nlm.nih.gov/pubmed/22733409

bstract
PURPOSE:

To investigate cerebrospinal fluid (CSF) dynamics in the aqueduct of Sylvius in multiple sclerosis (MS) patients and healthy controls (HC) using cine phase contrast imaging.
MATERIALS AND METHODS:

In all, 67 MS patients (48 relapsing-remitting [RR] and 19 secondary-progressive [SP]), nine patients with clinically isolated syndrome (CIS), and 35 age- and sex-matched HC were examined. CSF flow and velocity measures were quantified using a semiautomated method and compared with clinical and magnetic resonance imaging (MRI) disease outcomes.
RESULTS:

Significantly decreased CSF net flow was detected in MS patients compared to HC (-3.7 vs. -7.1 μL/beat, P = 0.005). There was a trend for increased net positive flow between SP, RR, and CIS patients. Altered CSF flow and velocity measures were associated with more severe T1 and T2 lesion volumes, lateral and fourth ventricular volumes, and third ventricular width in MS and CIS patients (P < 0.01 for all). In CIS patients, conversion to clinically definite MS in the following year was related to decreased CSF net flow (P = 0.007). There was a trend between increased annual relapse rate and altered CSF flow/velocity measures in RRMS patients (P < 0.05).
CONCLUSION:

CSF flow dynamics are altered in MS patients. More severe clinical and MRI outcomes in RRMS and CIS patients relate to altered CSF flow and velocity measures.

[uprightdoc]

Thanks for the link Robert. There are so many studies now on CSF and craniospinal hydrodynamics that it's incredible to me. There were very few when I started. As I mentioned in my book, I was investigating hydrocephalus because of the artificially deformed skulls I was studying at the museum. While searching for more information I found a textbook at a hospital library sale called Neurology by Victor and Adams. The section on hydrocephalus briefly covered a condition called Normal Pressure Hydrocephalus. It stated that neurosurgeons always suspected venous drainage problems as a cause of NPH. The problems is they never found blockages of the veins in the brain. The problem is they didn't look outside the brain for blockages, such as in the vertebral and jugular veins. Hakim and Adams were neurosurgeons who were pioneers in Normal Pressure Hydrocephalus research, which is also known as Hakim-Adams syndrome. That book started me on my journey with CSF flow. Physical anthropology provided the link to the vertebral veins.

[blossom]

Would this new discovery have anything to do with your thinking? Of course blood supply and spinal fluid supply is important no matter what part we are dealing with.



https://hms.harvard.edu/news/synaptic-shortcut

[uprightdoc]

Hello Blossom,

It's nice to hear from you. The article is interesting from an anatomical-physiological-academic perspective but not that helpful in understanding neurodegenerative conditions involving the basal ganglia, such as Parkinson's and Huntington's Chorea, as well as others.

Schizophrenia is associated enlarged ventricles, called ventriculomegaly. Ventriculomegaly is a sign of atrophy (shrinkage) of the brain or hydrocephalus. Epilepsy is associated with schizophrenia. Hydrocephalus can provoke seizures. Ischemia (decreased blood flow) to the brain can also provoke seizures. Blockage of blood and CSF flow can cause ischemia and hydrocephalus and subsequent seizures and schizophrenia. Hydrocephalus and normal pressure hydrocephalus have also been associated with psychosis, dementia, mania, depression, bipolar and other affective disorders. There are far more important issues to study regarding neurodegenerative and neurological conditions, especially issues involving circulations and fluid mechanics in the brain and cord.

[wallace]

Upright doc or anyone. What about sleeping upside down!!!!?????