Brainstem: Difference between revisions

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(→‎Evidence: I cited a primary source article describing the brainstem's control of the ANS. I also internally linked to the ANS MEpedia page.)
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There are anecdotal accounts of all ME/CFS symptoms, including [[Postural orthostatic tachycardia syndrome|POTS]] and fatigue, going away after a craniocervical fusion to correct the brainstem compression.<ref>{{Cite news|url=https://forums.phoenixrising.me/index.php?threads/have-you-ruled-out-chiari-as-a-cause-of-your-cfs.56908/#post-945253|title=Have you ruled out Chiari as a cause of your CFS|work=Phoenix Rising ME / CFS Forums|access-date=2018-10-26|language=en-US}}</ref>
There are anecdotal accounts of all ME/CFS symptoms, including [[Postural orthostatic tachycardia syndrome|POTS]] and fatigue, going away after a craniocervical fusion to correct the brainstem compression.<ref>{{Cite news|url=https://forums.phoenixrising.me/index.php?threads/have-you-ruled-out-chiari-as-a-cause-of-your-cfs.56908/#post-945253|title=Have you ruled out Chiari as a cause of your CFS|work=Phoenix Rising ME / CFS Forums|access-date=2018-10-26|language=en-US}}</ref>


As the brainstem is central to regulating the autonomic nervous system, it is perhaps unsurprising that dysautonomia (such as POTS) can be corrected by correcting brainstem compression.
As the brainstem is central to regulating the [[autonomic nervous system]],<ref>{{Cite journal|last=Martín-Gallego|first=A.|last2=González-García|first2=L.|last3=Carrasco-Brenes|first3=A.|last4=Segura-Fernández-Nogueras|first4=M.|last5=Delgado-Babiano|first5=A.|last6=Ros-Sanjuán|first6=A.|last7=Romero-Moreno|first7=L.|last8=Domínguez-Páez|first8=M.|last9=Dawid-Milner|first9=M. S.|date=2017|title=Brainstem and Autonomic Nervous System Dysfunction: A Neurosurgical Point of View|url=https://www.ncbi.nlm.nih.gov/pubmed/28120078|journal=Acta Neurochirurgica. Supplement|volume=124|pages=221–229|doi=10.1007/978-3-319-39546-3_34|issn=0065-1419|pmid=28120078}}</ref> it is perhaps unsurprising that dysautonomia (such as POTS) can be alleviated by correcting brainstem compression.
==Diagnosis==
==Diagnosis==
Brainstem compression is diagnosed via dynamic imaging, such as flexion-extension MRIs and rotational CT scans. The most common measurements used to diagnose and quantify brainstem compression are the Clivo-Axial Angle, the Grabb-Oakes Measurement, and the Basion-Dens Interval.<ref name=":1" />
Brainstem compression is diagnosed via dynamic imaging, such as flexion-extension MRIs and rotational CT scans. The most common measurements used to diagnose and quantify brainstem compression are the Clivo-Axial Angle, the Grabb-Oakes Measurement, and the Basion-Dens Interval.<ref name=":1" />

Revision as of 23:37, October 26, 2018

Brainstem Compression often occurs as a result of craniocervical instability (CCI).[1][2]

Evidence[edit | edit source]

Recent peer-reviewed research indicates that mechanical brainstem compression can be directly responsible for dysautonomia and fatigue.[1][2] When patients had a fusion surgery to correct their brainstem compression, their symptoms of brainstem compression significantly improved or resolved completely.[2]

There are anecdotal accounts of all ME/CFS symptoms, including POTS and fatigue, going away after a craniocervical fusion to correct the brainstem compression.[3]

As the brainstem is central to regulating the autonomic nervous system,[4] it is perhaps unsurprising that dysautonomia (such as POTS) can be alleviated by correcting brainstem compression.

Diagnosis[edit | edit source]

Brainstem compression is diagnosed via dynamic imaging, such as flexion-extension MRIs and rotational CT scans. The most common measurements used to diagnose and quantify brainstem compression are the Clivo-Axial Angle, the Grabb-Oakes Measurement, and the Basion-Dens Interval.[2]

Treatment[edit | edit source]

A cervical collar can be tried to see if it helps alleviate the neurological symptoms (even if only partially). However, a cervical collar is not an actual treatment for CCI. The standard treatment to correct brainstem compression is a craniocervical fusion surgery,[2] performed by a CCI-literate neurosurgeon.

See also[edit | edit source]

References[edit | edit source]

  1. 1.0 1.1 Henderson, Fraser C.; Henderson, Fraser C.; Wilson, William A.; Mark, Alexander S.; Koby, Myles (March 3, 2017). "Utility of the clivo-axial angle in assessing brainstem deformity: pilot study and literature review". Neurosurgical Review. 41 (1): 149–163. doi:10.1007/s10143-017-0830-3. ISSN 0344-5607. PMC 5748419. PMID 28258417.
  2. 2.0 2.1 2.2 2.3 2.4 Henderson, Fraser C.; Wilson, William A.; Mott, Stephen; Mark, Alexander; Schmidt, Kristi; Berry, Joel K.; Vaccaro, Alexander; Benzel, Edward (July 16, 2010). "Deformative stress associated with an abnormal clivo-axial angle: A finite element analysis". Surgical Neurology International. 1. doi:10.4103/2152-7806.66461. ISSN 2152-7806. PMC 2940090. PMID 20847911.
  3. "Have you ruled out Chiari as a cause of your CFS". Phoenix Rising ME / CFS Forums. Retrieved October 26, 2018.
  4. Martín-Gallego, A.; González-García, L.; Carrasco-Brenes, A.; Segura-Fernández-Nogueras, M.; Delgado-Babiano, A.; Ros-Sanjuán, A.; Romero-Moreno, L.; Domínguez-Páez, M.; Dawid-Milner, M. S. (2017). "Brainstem and Autonomic Nervous System Dysfunction: A Neurosurgical Point of View". Acta Neurochirurgica. Supplement. 124: 221–229. doi:10.1007/978-3-319-39546-3_34. ISSN 0065-1419. PMID 28120078.