Implications of Cervical-Cranial Instability in MS: Links to Cerebral Palsy

I have recently been enlightened as to the many challenges associated with Multiple Sclerosis (MS) as well as to the very complex and diverse manifestations.  Although my professional experience and expertise is more deeply rooted in Cerebral Palsy (CP) and general movement dysfunction, my recent investigations and research over the last few months has resulted in some rather interesting links between CP and MS.  These links are note intuitive and have required some analysis to arrive to, however I feel that they are valid concepts to investigate and examine further.
These links are very specific in nature and center around Chronic Cerebrospinal Venous Insufficiency (CCSVI) as well as the presence of cervical-cranial instability (Atlas instability).  My investigation is on-going and therefore relatively "young", however my understadning of this phenomenon is that this Atlas instability (misalignment) transmits compressive forces to the brainstem which in turn may produce venous occlusion resulting in chord ischemia.  This particular manifestation (cervical-cranial instability / misalignment) is quite common and characteristic in individuals with CP.  They manifest profound connective tissue (fascial) weakness that is global in nature...therefore this weakness in the neck is manifest by significant cranial-cervical connections which are typically characterized by complete loss of head control. In addition to this, CP is also characterized by developmental dysfunction...more specifically disrupted establishment of proper bony alignment of the cranium.  This results in sutural deformities and altered bony alignment.  The skeletal distortions contribute to a profound muscular imbalance which further exacerbates the manifestations of the cervical-cranial weakness.

The most interesting finding in my work in CP is that while the structural defficiency remains in place, motor intelligence is still quite actively engaged.  Therefore, there are a number of "intrinsic compensations" that take place.  To use a term from CP expert, Leonid Blyum:  "The instability at this level can be considered as an intrinsic de-capitation".   One of these compansations is the active engagement of the mouth...more specifically the opening of the mouth.  It is very common to observe CP children with their mouth consistently open.  While there are mal-occlusion issues also involved, the most interesting phenomenon occurs when they actively want to stabilize their head or engage in some dynamic performance: They open their mouth very wide and keep it open.  This can be considered as a mechanical "bypass" through which head stability is achieved.  By contracting certain muscles in the jaw, they can artificially stabilize the head and therefore be able to achieve a "quasi-stable" head position which then allows them to improve tracking and proprioceptive performance. This stability is derived from the activation of muscles on the anterior surface of the face /neck to mechanically lock the posterior neck.  In CP, this compensation is also demonstrated by intermitent tongue-thrusting.  This phenomenon draws very interesting links to MS and the focus on dental dysfunction.  My investigation has also revealed that clenching of the jaw is a common occurence that contributes to constant headache and potentially sleep disturbances.  These are physiological stressors that contribute to further exacerbation of the symptomatic challenges in MS.  Although in MS the jaws are clenched and in CP the jaw is held open, it indicates a very tangible link between the cranial-cervical instability and performance of the jaw.  The specific interventions to improve the stability of the cervical-cranial connection in CP has yielded very tangible and measurable reduction in the compensatory actions of the jaw.

In summary, I am aware that my formulations are quite "raw" and my understanding still needs to be populated by more investigation and discussion with experts in the field...however, there is significant precedent to suggest that a focused approach to the cervical cranial instability (without the use of aggressive / invasive procedures) can have very profound positive contribution to improving venous flow, reduction of prevalence of dental dysfunction and associated challenges, and ultimately contribute to a more stable and manageable condition.  I would like to thank my good friend, Jamie Chalmers for introducing me to the MS world with such drive and passion...and I encourage any and all comments and feedback that will help to contribute to the formulation of non-invasive interventions that can be immediately available for the MS community.  I will be continuing my raw investigations and hopefully will be able to share some productive information / demonstration in the very near future!  Best regards, Gavin.