Monday, July 19, 2010

Medical Controversy: Multiple Sclerosis is a Vascular Disease?

When new unproven treatments appear I tend to think that it will be the medical profession that pushes them before they are shown to work. I keep forgetting the other side of the equation. Namely the patients.

In 1995 Elena Ravalli started suffering from the symptoms of multiple sclerosis (MS). It so happens that her husband is a professor of medicine at the University of Ferrara in Italy. He went looking for the solution to MS and came across an interesting finding. Her husband, Paolo Zamboni, went looking and found a potential link between MS and blocked veins that drain blood from the brain.

It may be that the blocked veins allow iron and other substances in the blood to cross to cerebrospinal fluid where they cause damage.

Then he performed a simple operation on his wife alongs the lines of an angioplasty. He unclogged veins and let blood flow freely. His wife hasn't had an attack since.

A couple of his scientific papers are accessible online. They do tend to have the dense titles of most scholarly medical research. For example there is Chronic cerebrospinal venous insufficiency in patients with multiple sclerosis and the only slightly more accessible The Big Idea: Iron-dependent inflammation in venous disease and proposed parallels in multiple sclerosis.

I first heard of this research in late 2009 when The Globe and Mail covered the background of his work.

With early promising results (beyond just his own wife) patients with MS have jumped on the potentially simple cure. If a quick procedure to unblock some veins can stop and possibly reverse MS that is light years beyond any previous therapy. It makes complete sense to see patients actively trying to get treatment.

And this is one of those cases where the researcher himself is urging patience and caution. Zamboni himself says that doctors who are performing the procedure are acting irresponsibly but then he tempers his words saying that vascular neurologists should recommend the procedure for patients with advanced cases. Either way much more research needs to be done. But that isn't stopping patients. They are travelling to places where doctors will perform the procedure.

Put yourself in the shoes of someone with MS. There is a potentially revolutionary breakthrough that can remove MS completely with a simple surgery but it is still being researched. If the chances of side effect or complications from the surgery was low would you travel to the ends of the earth for treatment?

Most of us would if we could afford it.

To those that have a disease medical science will usually seem too slow and too cautious.

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