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Thread: Question for Dr. Wise

  1. #21
    thanks Ox, when I right click nothing comes up as save image. things should be easy, never are. I'm going to get a printer.

    keeping on

  2. #22
    Imight, yes trial have started and things look good for 2011. My hope is that we will have a lot more to talk about in the coming months.

    keeping on

  3. #23
    Senior Member 0xSquidy's Avatar
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    Quote Originally Posted by keeping on View Post
    thanks Ox, when I right click nothing comes up as save image. things should be easy, never are. I'm going to get a printer.

    keeping on
    You should see something similar. You can try another option: resize this window so you can see both the image and your desktop. Drag and drop the image to your desktop.
    Don't ask what clinical trials can do for you, ask what you can do for clinical trials.

    Fenexy: Proyecto Volver a Caminar

    http://www.fenexy.org (soon in english too)

  4. #24
    keeping on,one more option,-after opening the link (left click on it), under the tab "Page"(IE browser) choose command "Send Page by E-mail" and send it to yourself.

  5. #25
    Quote Originally Posted by Wise Young View Post
    Amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS), transverse myelitis (TM), cauda equina syndrome (CES) overlap with traumatic spinal cord injury (SCI) but differ in several important ways. Let me try to express in graphically. As illustrated in the following figure, SCI shares characteristics with the other conditions.

    Traumatic spinal cord injury may be associated with demyelination, axon loss, and neuron loss, depending on the segmental level and severity. If the injury occurs in the thoracic level, it damages axons and myelin in spinal tracts passing through the injured segment with relatively few and inconsequential neuron loss. However, if it occurs in the cervical or lumbar area, there may be loss of neurons innervating the hand and arm muscles (C5-8, T1) or breathing (C3-4). If it occurs in the lumbar level, it may damage neurons responsible for leg movement (L1-5, S1-3), anal sphincter and sensation (S4-5).

    TM is an inflammatory condition that causes damage to the spinal cord at a particular segmental level. It causes damages to neurons, axons, and myelin in the affected segments. It may involve ischemia (loss of blood flow) and inflammation (infectious) of the segment. From that perspective, it is the most similar to SCI. It shares demyelination, axon damage, and neuronal loss with SCI.

    MS is an autoimmune condition that causes damage primarily to myelin and secondarily to axons. In one type of MS, the remitting/relapsing form, the spinal cord undergoes repeated bouts of demyelination and and remyelination and drugs such as interferon are used to prevent relapses. People with MS share demyelination and axon damage with people who have SCI.

    ALS is a neurodegenerative disease that appear to affect mostly motoneurons. ALS is relentlessly progressive and less than 5% of people survive 5 years after the diagnosis. It affects mostly motoneurons although it may affect other neurons at later stages. Hence, it shares neuronal loss with SCI.

    CES is due to an injury to the lumbosacral roots. In that sense, they are peripheral nerve injuries. However, the injury to the roots may be close enough to the spinal cord to cause motoneuronal death as well. The main obstacle to recovery is lack of regeneration of dorsal root sensory axons in the spinal cord, lack of use, and reflexes. It shares axonal loss (of the toot and segmental neuronal loss)

    So, many of the therapies developed for these five conditions can be applied to some extent to each other.

    Wise.
    Dr Young, how does ADEM fit into this picture? I am a female diagnosed with ADEM at age 61, previously in excellent health. My MRI's showed intense spinal cord swelling in the C and T sections and a "string" of lesions. After Prednisone treatments, the spinal cord swelling is gone and the lesions are almost all healed. But I have neuropathic pain and sensations on my entire left side, shoulder down - arm, torso, and leg. My Drs seem happy, but my pain is disabling even with Gabapentin and Capsaicin. Does ADEM entail damage to neurons, axons, and myelin or only myelin? Thank you.

  6. #26
    Quote Originally Posted by KYLady View Post
    Dr Young, how does ADEM fit into this picture? I am a female diagnosed with ADEM at age 61, previously in excellent health. My MRI's showed intense spinal cord swelling in the C and T sections and a "string" of lesions. After Prednisone treatments, the spinal cord swelling is gone and the lesions are almost all healed. But I have neuropathic pain and sensations on my entire left side, shoulder down - arm, torso, and leg. My Drs seem happy, but my pain is disabling even with Gabapentin and Capsaicin. Does ADEM entail damage to neurons, axons, and myelin or only myelin? Thank you.
    KYLady,

    By ADEM, I assume that you referring to acute disseminated encephalomyelitis. As you know, ADEM is a condition where there is generalized inflammation in the brain and spinal cord, presumably from an immune or inflammatory response to infection.

    I wish that I knew what the damage is in human ADEM. What we do know is that one can provoke ADEM in mice that produces changes in the brain and spinal cord that look similar to multiple sclerosis. Because of this, ADEM is often treated like it is MS. It is considered to be a form of MS (Source).

    Wise.

  7. #27
    Thank you, Dr Young. Yes, I was referring to acute disseminated encephalomyelitis. My Drs had difficulty in diagnosing it because it is so unusual in adults. I did have a virus 2 weeks prior to initial symptoms. They considered MS, but I'm too old for that. They tested for Devics, etc. With heavy IV steroids, my symptoms greatly diminished, per MRI's, and a year later, I'm much improved. But they don't know why I have so much sensory damage. CSN damage? Peripheral nerve damage? both? Myelin only? Myelin and nerve damage?

    I'm excited about all the significant research and there is no doubt that effective therapies are on the horizon. But, if Drs can't tell where damage is located & what kind it is, how can they determine what new therapy might be applied and where? So little is known about ADEM.

  8. #28

    Thumbs up

    Hello doc i have had my injury for six months now(cauda equina) i lost b&b function but could still walk. I could push urine out but it is extremely painful when i do so. Should i continue doing that or should i cease and decist
    ? Also if i start feeling sensation will i recover function? If so how long does it usually take for nerves to regenerate and if nerves start to regenerate do they fully recover? Thanks Doc
    Last edited by dan fly; 01-02-2011 at 06:28 AM.

  9. #29

    question for Dr.Young

    Dear Dr. Young

    I had 4 years ago a C-6 fracture with as result complete sci. The result of MRI was myelopathy (this was the term which the radiologist used)
    Now after 4 years I let make a nother MRI and the result is total transection.

    - can a fracture cause a total/complete transection ?
    - is MRI enough sensitive to detect a transection? I know somebody who was told to have a transection bij GSW but during the decompression surgery was no any transection to see.
    - has a transection consequences for future cell transplantation?

    Friendly regards.

  10. #30
    Quote Originally Posted by dan fly View Post
    Hello doc i have had my injury for six months now(cauda equina) i lost b&b function but could still walk. I could push urine out but it is extremely painful when i do so. Should i continue doing that or should i cease and decist
    ? Also if i start feeling sensation will i recover function? If so how long does it usually take for nerves to regenerate and if nerves start to regenerate do they fully recover? Thanks Doc
    dan,

    I suggest that you go to a urologist and get a study of your bladder to figure out what is going on. The fact that you get pain when pushing is interesting and worrisome. It suggests that you have sensation but have lost your motor responses. Where is the pain and what is it like?

    Regeneration of the cauda equina is difficult to predict. It may be limited if you have a lot of scar tissue in the cauda equina. It may also be limited if the injury is close to the conus (the tip of the spinal cord). Finally, sensory regeneration tends to be limited because the axons cannot grow back into the spinal cord.

    Wise.

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