The following are pertinent references that may be helpful for doctors
or patients suffering from Multiple Sclerosis. For links to
informative
sites on the internet click on the following: Multiple
Sclerosis
- Internet Resources
Chuanshen Wu, Ansi Chang, Maria C. Smith, Roy Won, Xinghua Yin, Susan
M. Staugaitis, Dimitri Agamanolis, Grahame J. Kidd, Robert H. Miller,
and Bruce D. Trapp Newly
Discovered Primitive Cells Produce Widespread Remyelination. The Journal of Neuroscience, June
17, 2009, 29(24): 7649–7657.
The prospect of replenishing damaged cells in the brain using
transplanted stem cells is perhaps most hopeful in the case of
replacing oligodendrocytes in demyelinating diseases such as multiple
sclerosis (MS). Wu et al. report what might be a landmark step in this
direction: the discovery of a previously unrecognized population of
cells in the adult subventricular zone (SVZ) that can differentiate
into neurons, astrocytes, and oligodendrocytes, depending on culturing
conditions. These cells, distinguishable from other SVZ cells by their
expression of _4 tubulin (_T4), were scattered throughout the SVZ in
humans, and their numbers were significantly elevated near lesions in
MS patients. _T4-expressing cells exhibited several features of stem
cells in addition to multipotency: low basal proliferation rate,
contact inhibition via homophilic adhesion, and resistance to
dissociation. Most importantly, when injected into the brain of
myelin-deficient rats, T4 cells produced mature oligodendrocytes that
migrated far from the injection site and produced widespread
remyelination.
Dougherty, P.; Lawrence, D.; Chiropractic
management of musculoskeletal pain in the multiple sclerosis patient
Clinical Chiropractic .
2005 Jun Vol. 8(2) Pgs. 57-65
ABSTRACT: Multiple sclerosis (MS) is a common disabling disease. Five
to 10% of MS patients will enter a long-term care facility. The
majority of MS patients suffer from some type of pain syndrome. Pain
syndromes in MS can be divided into three categories: acute; subacute
or paroxysmal and chronic. Chronic pain syndromes have been anecdotally
reported to respond to mechanical treatments. Chiropractic care has
shown efficacy in the treatment of chronic spinal pain. Chiropractic
care may represent a viable treatment option for the MS patient
suffering from chronic pain syndromes. Chiropractic care has been
successfully integrated into a chronic care facility which is
affiliated with a private university medical school. Chiropractic has
been utilized in this setting for pain management of MS patients
suffering from chronic pain syndromes. Preliminary findings from this
clinic suggest that chiropractic may represent one treatment
alternative for chronic pain in MS patients in a long-term care
facility. Further studies will be needed to definitively determine the
efficacy of chiropractic for the management of chronic pain in the MS
patient.
Murphey, D.R.; Williams, D.S.; Complaint
of Foot Drop Leads to Diagnosis of Multiple Sclerosis: A Case Report
Journal of the American Chiropractic
Association .2004 May ; 41(5): 32-5
ABSTRACT: Multiple sclerosis (MS) is a neurological disease that occurs
in 5 to 100 per 100,000 people. Thus, it is reasonable that, as doctors
of chiropractic become increasingly recognized as primary-contact
neuromusculoskeletal specialists, most will encounter undiagnosed MS at
some point in their careers. In these cases, the doctor of chiropractic
will be responsible for making, or at least suspecting, the diagnosis
and coordinating the appropriate referral. Reported here is an unusual
case of a woman who was referred to a chiropractic spine center with
the sole complaint of foot drop, which was ultimately attributed to MS.
Elster, E.L.; Eighty-One Patients
with Multiple Sclerosis and Parkinson’s Disease Undergoing Upper
Cervical Chiropractic Care to Correct Vertebral Subluxation: A
Retrospective Analysis Journal of Vertebral Subluxation Research
. 2004; 2004(1): 1-9
ABSTRACT: Objective: The objective of this article is threefold: to
examine the role of head and neck trauma as a contributing factor to
the onset of Multiple Sclerosis (MS) and Parkinson’s disease (PD); to
explore the diagnosis and treatment of trauma-induced injury to the
upper cervical spine through the use of protocol developed by the
International Upper Cervical Chiropractic Association (IUCCA); and to
investigate the potential for improving and arresting MS and PD through
the correction of traumainduced upper cervical injury. Data from 81 MS
and PD patients who recalled prior trauma, presented with upper
cervical injuries, and received care according to the above protocol are
reviewed.
Clinical Features: Each patient was examined and cared for in the
author’s private practice in an uncontrolled, non-randomized
environment over a five-year period. Of the 81 MS and PD patients, 78
recalled that they had experienced at least one head or neck trauma
prior to the onset of the disease. In order of frequency, patients
reported that they were involved in auto accidents (39 patients);
sporting accidents, such as skiing, horseback riding, cycling, and
football (29 patients); or falls on icy sidewalks or down stairs (16
patients). The duration between the traumatic event and disease onset
varied from two months to 30 years.
Intervention and Outcome: Two diagnostic tests, paraspinal digital
infrared imaging and laser-aligned radiography, were performed
according to IUCCA protocol. These tests objectively identify
trauma-induced upper cervical subluxations (misalignment of the upper
cervical spine from the neural canal) and resulting
neuropathophysiology. Upper cervical subluxations were found in all 81
cases. After administering treatment to correct their upper cervical
injuries, 40 of 44 (91%) MS cases and 34 of 37 (92%) PD cases showed
symptomatic improvement and no further disease progression during the
care period.
Conclusion: A causal link between trauma-induced upper cervical injury
and disease onset for both MS and PD appears to exist. Correcting the
injury to the upper cervical spine through the use of IUCCA protocol
may arrest and reverse the progression of both MS and PD. Further study
in a controlled, experimental environment with a larger sample size is
recommended.
Page, S.A.; Verhoef, M.J.; The use of
complementary therapies, including cannabis, by people with multiple
sclerosis Focus
on Alternative and Complementary Therapies .2002
Mar; 7(1): 103
ABSTRACT: Referenced From: 8th Annual Symposium on Complementary Health
Care. 6th-8th December 2001, Exeter, UK
Objective:
Little information is available on complementary and alternative
medicine (CAM) use among multiple sclerosis (MS) patient in Canada. In
particular, no systematic inquiry has looked at the (controversial) use
of cannabis as a herbal therapy. Therefore, we described CAM use by
adults with MS and explored the use of cannabis and the impact this has
on the lives of MS patients.
Materials and methods:
A mailed questionnaire was sent to a random sample of adult MS patients
in Southern Alberta. A sample of patients using cannabis, who were
willing to participate in personal interview, were interviewed in
person using qualitative methods:
Results:
The survey response rate was 65%. Twenty-five percent were male and the
mean age was 48 years (SD 10.7). Seventy percent currently used CAM,
most commonly vitamins (79%), followed by massage therapy (43%),
evening primrose oil (42%), prayer (36%) and chiropractic (30%). The
median number of therapies used was seven. CAM was mostly used to
improve health and to lessen symptoms. Those who were not using CAM
mostly said they did not have enough information on it. Cannabis was
currently used by 25 of respondents; 20 others had used cannabis during
the past 2 years, but stopped because of cost and side-effects. The
majority felt that cannabis improved the disease's symptoms. Fifteen
in-depth interviews were conducted. Themes arising in the interviews
will be presented at the meeting.
Conclusion:
This study has generated new information that is potentially useful for
patients, providers and policy makers.
Elster, E.L.; Upper Cervical
Chiropractic Management of a Multiple Sclerosis Patient: A Case Report
Journal of Vertebral Subluxation
Research . 2001 ; 4(2)
ABSTRACT: This article reviews the upper cervical chiropractic care of
a single patient with Multiple Sclerosis (MS). This 47-year-old female
first experienced symptoms of Multiple Sclerosis (MS) at age 44, when
she noticed cognitive problems and loss of bladder control. After
viewing multiple lesions on MRI (MS plaques), her neurologist diagnosed
her with MS. Two years later, she noticed additional symptoms of leg
weakness and paresthesias in her arms and legs. Her symptoms
progressively worsened without remission, so her neurologist
categorized her as having chronic progressive MS and recommended drug
therapy (Avonex).
Upon initial examination of this patient, evidence of an upper cervical
subluxation was found using precise upper cervical radiographs and
paraspinal digital infrared imaging. The patient’s medical history
included one possible mechanism (a fall approximately ten years prior),
which could have caused her upper cervical subluxation. The patient was
placed on a specially designed knee-chest table for adjustment, which
was delivered by hand to the first cervical vertebra according to
radiographic findings.
Monitoring of the patient’s progress was through doctor’s observation,
patient’s subjective description of symptoms, thermographic scans,
neurologist’s evaluation and MRI. The patient was managed with upper
cervical chiropractic care for two years.
After four months of upper cervical chiropractic care, all Multiple
Sclerosis ( MS) symptoms were absent. A follow-up MRI showed no new
lesions as well as a reduction in intensity of the original lesions.
After a year passed in which the patient remained asymptomatic, another
follow-up MRI was performed. Once again, the MRI showed no new lesions
and a continued reduction in intensity of the original lesions. Two
years after upper cervical chiropractic care began, all MS symptoms
remained absent.
This case report revealed that this specific upper cervical procedure
(thermal imaging, cervical radiographs, and knee-chest adjustments) was
associated with a successful outcome for a patient with Multiple
Sclerosis. Post MRI’s, post thermographic scans, and the patient’s
neurologist’s evaluation all suggested the intervention of upper
cervical chiropractic care may have stimulated a reversal in the
progression of Multiple Sclerosis.
Wiese, BC.; Exploring the
Relationship Between Multiple Sclerosis Symptomatology and Chiropractic
Care Through a Prospective Case Series The Journal of Chiropractic Education
. 2000 Spr; 14(1): 55.
ABSTRACT: Multiple sclerosis (MS) is a demyelinating disease of the
central nervous system afflicting over 250,000 persons in the United
States alone. While the etiology of MS is currently unknown, much
clinical evidence points to an infectious process involving an unknown
agent, causing an immune response against one's own nervous system in
genetically susceptible persons. The resulting inflammation of the
central nervous system tissues produces a wide variability in the
clinical sense, with subtypes of MS ranging from remitting-relapsing
varieties to a chronic progressive expression of MS. No cure exists for
MS, and as a result most therapies are directed toward the alleviation
of MS-related symptomatology while promoting self-sufficiency. The
medical approach toward MS symptom relief generally includes a vast
array of pharmaceutical agents, diet modification, physical therapy,
and addressing associated psychological issues. Alternatives to these
treatment modalities have increasingly become available, most with
little more than anecdotal support. Described is a prospective case
series involving chiropractic care with four MS patients, each
diagnosed with the chronic progressive form of the disease. The purpose
of this series was to investigate any significant relationship between
chiropractic care delivery and MS-related symptomatology.
METHODS: Four patients were selected from a local MS support group,
each with a diagnosis of chronic progressive MS (confirmed by imaging).
A clinical trial of 6 months duration was undertaken, utilizing two
separate and distinct methods of chiropractic care: Three of the
patients were treated over the course of 6 months utilizing full-spine
chiropractic manipulative therapy, while the fourth was treated using
only Toggle recoil upper cervical technique. Subjective and objective
parameters were measured initially, and every 4 weeks until the
completion of the 6 month trial. These outcome measures included the
SF-36 Health Survey, as well as the MS-ADL Scale (Gulick); strict
physical examination criteria were also followed at these intervals.
Lastly, each patient was encouraged to keep a daily diary in which to
record pertinent subjective data.
RESULTS: Data collected over the course of the clinical trial
illustreates measurable change in various "quality of life" issues.
Data retrieved from SF-36 surveys measured the following: General
Health, Physical Functioning, Limitations Due to Physical Health,
Limitations Due to Emotional Health, Pain, Energy/Fatigue, and
Emotional Well-Being. The MS-ADL Scale (Gulick) measures were
considerably more specific, including: Eating, Dressing, Walking,
Transfer, Travel, Bathing, Toileting, Recreation/Socializing,
Sensory/Communication, and Intimacy. Data collected indicated that
change was primarily seen in categories involving physical ability,
energy level, and bodily pain; these areas are discussed fully, with a
comparison being made between the two treatment groups.
DISCUSSION: Presentations of multiple sclerosis vary greatly, inthe
clinical sense. Many patients are affected with change in physical
ability or general musculoskeletal function as a direct manifestation
of the disease. compensation for these deficits is certain. These
compensatory efforts may in fact create still more symptoms, negatively
influencing the patient's perception of well-being. When normal spinal
motion patterns have been altered, either directly or indirectly,
chiropractic manipulative therapy may be indicated. Correction of these
spinal aberrations may positively impact the MS patient's quality of
life.
CONCLUSION: This case series has suggested that chiropractic care is a
viable, noninvasive form of treatment for musculoskeletal symptoms
associated with multiple sclerosis. While promising, the results of
this study indicate the need for further research in this area.
Wiese, BC; Clinical Presentation of Chronic Spinal Adhesive
Arachnoiditis
within a Chiropractic Teaching Clinic Journal of
Chiropractic
Education. 1999 Spr; 13(1): 83
ABSTRACT: Multiple sclerosis (MS) is a debilitating disease of the
central
nervous system that affects thousands of persons per year. While MS
currently
has no cure, most available therapies are directed toward alleviation
of
associated symptomatology, while promoting self-sufficiency. Medical
approaches
include use of pharmaceuticals, diet and behavior modification, and
physical
therapy. Besides chiropractic manipulative therapy, alternative
therapies
for relief of symptomatology include acupuncture, bee venom, and a host
of
other remedies; the effectiveness of these is based substantially on
anecdotal
evidence. Multiple sclerosis carries essentially three levels of
diagnosis
confirmation: possible, probable, and definite. To date, there have
been
only two published accounts of the effects of chiropractic care on the
symptoms
associated with multiple sclerosis: one with a diagnosis of possible
MS,
with a second involving a probable MS diagnosis, later confirmed with
MRI.
This prospective case study involves a patient with a diagnosis of
definite
MS, and illustrates a potentially beneficial relationship between
chiropractic
care and MS-related symptomatology.
Herzog, J; Electrodiagnostic Testing in Clinical Practice: Part Two
Journal of the American Chiropractic Association. 1998
Dec;
35(12): 22-3
ABSTRACT: Somatosensory EPs are used to test (1) the peripheral nervous
system
and (2) the large-fiber tracts in the central nervous system. Clinical
utility
of SEP stems from the close relationship between the EP waveforms and
specific
anatomic structures. SEPs are commonly used in cases where multiple
sclerosis
and other demyelinating diseases are suspected. SEPs also have useful
clinical
information to yield in infants when neurological abnormalities are
suspected,
in intraoperative monitoring, and when coma or brain death is present.
In
the chiropractic setting, short latency somatosensory-evoked potentials
yield
important clinical information in peripheral nerve lesions,
plexopathies,
radiculopathies, thoracic outlet syndrome, and spinal cord trauma. Many
of
these conditions are commonly encountered in the chiropractic setting,
and
SEPs offer a painless, noninvasive means to demonstrate an abnormal
sensory
system, uncover functional pathologies is the sensory system, locate
the
site of an anatomic lesion, and monitor objective changes in a
patient's
status throughout treatment.
Killinger, LZ; Azad, A; Multiple Sclerosis Patients Under
Chiropractic
Care: A Retrospective Study Palmer Journal of
Research.
1997 Jun Vol. 2(4) Pgs. 96-100
Jack, LE; The Relationship Between Psychosocial Variables and
Disease
Topics in Clinical Chiropractic. 1996 Dec Vol.
3(4)
Pgs. 25-31
ABSTRACT: Purpose: The purpose of this article is to describe a body of
literature
that explores the relationship between psychological factors and
physiological
responses that can enhance or inhibit healing. Method: A qualitative
review
of the literature pertaining to depression, stress, anxiety and their
relationships
to multiple sclerosis, HIV, and other disease processes was undertaken.
Summary:
There has been a great deal of research examining the relationship
between
psychosocial stressors, emotional states, and disease processes. Most
often,
this research has indicated a strong correlation between emotional
states
such as depresseion, anxiety and immune system functioning. Life
situations
such as loss, divorce, death of a loved one, job status change, and
thrill
seeking have all been linked to a decrease in immune response.
Likewise,
diseases such as multiple sclerosis, AIDS, cancer, and viral infections
have
been shown to be causally implicated in psychiatric conditions. There
are
approaches chirorpactors and other practitioners can take that would
allow
them to attend to these psychosocial variables and increase the
recovery
rate for some types of patients.
Kirby, S.; A Case Study: The Effects of Chiropractic On Multiple
Sclerosis
Chiropractic Research Journal. 1994; 3(1): 7-12
ABSTRACT: Management of a case with symptomotology indicative of
Multiple
Sclerosis. The condition, which currently has no known cure, responded
favorably
to chiropractic care using an upper cervical approach to reduce a
specific
subluxation complex.
Stude DE, Mick T. Clinical presentation of a patient with
multiple
sclerosis and response to manual chiropractic adjustive therapies. J
Manipulative Physiol Ther 1993
Nov-Dec;16(9):595-600
Northwestern College of Chiropractic, Bloomington, MN 55431.
OBJECTIVE: To present a clinical case presentation of a patient with
multiple
sclerosis (MS). Diagnostic criteria are presented, including advanced
imaging;
and, for the first time, a potential relationship between chiropractic
manual
adjustive therapies and the symptoms associated with MS is presented.
CLINICAL
FEATURES: A 32-yr-old male presented with numbness from the lower trunk
to
the distal lower extremities, anteriorly and posteriorly, bilaterally
equal.
There was a family history suggestive of MS, reflexes were hyperactive,
and
hypoesthesia was present with the neurological pinwheel exam. There was
evidence
to suggest biomechanical vertebral segmental dysfunction. A
second-opinion
medical neurological evaluation and multifocal demyelination lesions
confirmed
with magnetic resonance imaging reinforced the working impression.
Laboratory
screening was conducted but was non-revealing. INTERVENTION AND
OUTCOME:
Conservative chiropractic manual adjustive therapies were provided to
address
spinal segmental dysfunction and the patient reported complete absence
of
symptoms following the first treatment intervention. It was at this
time,
in order to rule out other possibilities and to confirm the working
impression
of MS, that a second opinion with a medical neurologist was
recommended.
CONCLUSION: Manual adjustive therapies appear to be responsible for the
dramatic
symptomatic relief provided for a patient diagnosed with MS. The
relative
risk-to-benefit ratio suggests that this approach may be appropriate as
an
alternative symptom management approach for MS patients, and future
research
efforts can and should direct the comprehensive management approach to
the
treatment of this disorder.
Rosquist, W.; An update on chiropractic's approach to multiple
sclerosis
Digest of Chiropractic Economics. 1988 Apr; 30(5): 78-81
Mrozek, J.; Multiple Sclerosis: An Exercise in Diagnosis
Journal of the Canadian Chiropractic Association. 1980
Mar;
24(1): 21
Haldeman, S.; Basic concepts in multiple sclerosis ACA
Journal of Chiropractic. 1979; 13: S37-S46
ABSTRACT: Multiple sclerosis is a disease of unknown etiology
characterized
by wide-spread occurrence of patches of demyelination in the nervous
system.
This disorder may present with signs or symptoms of motor weakness,
incoordination,
dysarthria, or sensory, ocular, auditory, vestibular and mental
disturbances.
Diagnosis requires a complete neurological history and examination plus
access
to such tests as visual and auditory evoked responses, cerebrospinal
fluid
analysis, computerized tomography and myelograpy. Proposed theories for
the
pathogenesis of multiple sclerosis include genetic predisposition,
viral
infection, immunologic defects and abnormal fatty acid metabolism.
There
is no known cure for multiple sclerosis and most treatment is geared
towards
general support during acute exacerbations followed by rehabilitation
and
palliation of symptoms. The prognosis is variable. All primary contact
health
practitioners should be familiar with this disease in order to assure
optimum
patient care. Research on possible effects of chiropractic care on
multiple
sclerosis has not been carried out.