What Causes MS?

The short answer is that no one knows what causes MS. Seriously. Sigmund Freud and others chalked it up to feminine hysteria. Frankly, most neurologists today seem to do the same until it is severe enough to show up on an MRI. MRIs are not sensitive to lesions at all--they kind of need to be knocked over the head with axonal damage.

For the last 40 years or so, MS has been assumed to be an autoimmune disorder. The immune system attacking the person's body. However, no one understands how or why this happens. It is amazing how doctors and pharmaceutical companies create videos such as this one, when the autoimmune theory is purely conjecture.

It is big bucks conjecture, though. MS drug therapies cost upwards for $40,000 per year. Imagine! And the best they can do is slow things down a bit for some people. For many people, they do absolutely nothing. Some people even get worse with the drugs--probably because of side effects. Every single one of these drugs functions by interacting with the immune system. They are called immunomodulators--trying to modulate the immune system. Patients have to stay on these drugs for the rest of their lives in order to slow the increase of disability. There is no cure for MS.

Blood flows throughout the body, right? It is not supposed to get into the brain. It is supposed to stay in its little channels--arteries and veins. But the autoimmune theory says that for some reason the body goes nuts on itself and is suddenly able to send immune attack cells from the bloodstream into the brain.

If the autoimmune theory is correct--why does the body attack itself? What sets it off? How do the immune cells get through the blood-brain barrier? Why do some people have frequent attacks and others go as long as 25 years between attacks? Does the immune system forget what it was doing? Maybe it has MS.

A new theory is called chronic cerebrospinal venous insufficiency (CCSVI). This theory has been laughed out of scientific circles for the last two years. The funny thing is that it is not a new theory. It is a resurrection of an old theory.

CCSVI theory proposes that MS is caused by veins that do not allow blood to flow properly. They back up, causing the pressure to increase in certain areas of the brain and spine. The increased pressure causes the body to develop new, tiny veins to try to get the blood out of where it is not supposed to hang out. These new veins are pretty crappy. But the problem is that the original veins were crappy--that is why they did not let the blood flow through them properly. And this blood flow problem "forces" blood into areas where it does not belong. Immune cells, toxins, and other not-brain-friendly stuff are in the blood. They go to town when they are let loose in the brain or spinal cord.

Autopsies have shown that the large veins in the necks of people with MS frequently have malformations. Sometimes there are issues with multiple branches, implying poor drainage efficiency. But frequently there are problems that would be impossible to see except with autopsy. Small flaps or membranes that impede the flow of blood.

This theory is controversial, allegedly because it is not supported by science. But frankly, the autoimmune theory is not supported by science. I think the theory is controversial, because it threatens the establishment. It would move MS treatment from the domain of neurologists to that of vascular surgeons.

Some vascular surgeons (including the one who came up with the CCSVI theory, an Italian man whose wife has MS) have been performing angioplasties on people with MS, with mostly good results. It is complicated. But now other scientists have begun supporting the theory. If it is correct, it would change the face of MS intervention.