Chronic Cerebrospinal Venous Insufficiency (CCSVI) is Not Associated With Multiple Sclerosis

The medical fraternity is divided over the theory whether chronic cerebrospinal venous insufficiency is linked with multiple sclerosis. Here’s what the latest research says.

There appears to be no link between chronic cerebrospinal venous insufficiency and multiple sclerosis (MS), in the findings of a new research published in CMAJ (Canadian Medical Association Journal).

Multiple Sclerosis Symptoms

Multiple sclerosis - Symptoms - Causes - Diagnosis - Treatment
Multiple sclerosis can be a severely disabling autoimmune disease that affects the myelin or insulating layer of the nerve fibers and typically has remissions and relapses

Multiple sclerosis is a central nervous system disease in which the immune system destroys the protective sheath covering the nerves. This causes a communication disturbance between the brain, spinal cord, and the other body parts. Gradually, the whole nervous system becomes dysfunctional. This disease has no cure. Managing the patient and reducing the symptoms is the only option.

Symptoms of multiple sclerosis vary and may include:

• Fatigue and becoming easily tired
• Numbness and tingling of legs and /or arms, dizziness
• Problems with balance and walking, slurred speech
• Blurring of vision
• Sensation of electric shocks when moving the head

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The symptoms may come and go in the early stages of the disease. Secondly, even slightest increase in body temperature can worsen the symptoms.

What is CCSVI?

Numbness and Tingling
Numbness and tingling are common symptoms, which could be due to a problem in nerves, blood supply or other systemic diseases.

Chronic cerebrospinal venous insufficiency or CCSVI is a condition in which the blood flow in the veins that drain the central nervous system is obstructed.

It is easy to see now the connection between CCVI and multiple sclerosis, since both of them have to do with malfunction of the central nervous system. The obstruction in CCSVI causes the blood flow to the heart slow down and blood may reflux back toward the brain and spine.

MS experts question vein disorder theory
British medical experts are questioning a new theory put forward by Italian vascular surgeon Dr. Paolo Zamboni that multiple sclerosis (MS) was caused by blocked veins in the neck or chest.

Professor Paolo Zamboni, a vascular surgeon from the University of Ferrara, Italy, found a link between pressure in the veins, iron deposition, and ulceration in venous disease of the legs. He applied the same theory to multiple sclerosis. His research showed that venous abnormalities are linked with multiple sclerosis because the veins responsible for blood flow out of the brain and spinal cord of patients with multiple sclerosis were abnormally narrowed or even blocked in some places.

Diagnostic criteria of CCSVI as proposed by Dr. Zamboni

According to Dr. Zamboni, diagnosis of CCSVI is based on the presence of at least two of the following five indicators:

• Blood reflux in internal jugular vein (IJV), vertebral veins, or both, with head in any position
• Blood reflux in deep cerebral veins
• Stenosis (abnormal narrowing of the veins) in IJV
• Flow not detected by Doppler in IJV or vertebral veins
• When the IJV looks wider in a sitting position than when lying on the back. This indicates abnormal venous blood drainage in sitting position

Contradictory research findings

CCSVI and multiple sclerosis is a much researched area. Not all studies agree with Dr. Zamboni’s theory. To the confusion of the scientific community, some studies find absolutely no evidence of CCSVI in people with MS, while others reveal that CCSVI is a real entity and can cause MS in some way.

Latest findings

The present research found no link between CCSVI and MS.

‘We detected no link between chronic cerebrospinal venous insufficiency and multiple sclerosis,’ reported lead author of the study Dr. Fiona Costello from the department of Clinical Neurosciences and Surgery, University of Calgary, Calgary, Alberta.

Further, the researchers also challenged Dr. Zamboni’s diagnostic criteria of CCSVI. For example they found that no patient with MS had more than one of the criteria set by Dr. Zamboni. Similarly, they did not agree with the phenomenon characterized as ‘reflux’ and cited their own theory regarding the ‘abnormality’.

‘We also identified several methodologic concerns that challenge the validity of the criteria used to define chronic cerebrospinal venous insufficiency, and in turn we dispute the authenticity of this diagnosis,’ she said.

References:

1. http://www.ccsvi.org/index.php/the-basics/what-is-ccsvi

2. http://www.overcomingmultiplesclerosis.org/About-MS/Causes-of-MS/CCSVI/

Source-Medindia