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Just got some test results back that showed abnormally high levels of lactic acid in my cerebrospinal fluid. What do you suggest?

Question:
Just got some test results back that showed abnormally high levels of lactic acid in my cerebrospinal fluid. My limited guess at this would be it's from poor brain oxygenation (I do have an abnormal brain SPECT, as well)?

Has anybody else had this show up in their LPs, seen it in the lit, and/or have any comments as to what this means?


Answer:
According to some recent studies, the herniation in Chiari Malformation is almost always caused by the skull case being too small in back, and actually physically compressing the structures of the hind brain (where the hypothalamus and cerebellum are). Many of the symptoms probably arise from this direct compression of the parts of the brain involved in autonomic function, data transfer (short term memory), the immune system, etc.

Blockage of cerebral-spinal fluid can come when the compressed brain protrudes into the opening of the spinal column enough to disturb flow. Pressure can build up either within the skull or in the spinal column from the blockage of cerebral-spinal fluid. This can cause additional pressure on the brain, the spinal cord , and the nerves where they emerge from the spinal cord.

Neurosurgeons who specialize in Chiari are beginning to redefine it in terms of the underdeveloped skull casing causing direct compression, rather than simply on herniation and blockage of cerebral-spinal fluid. The studies mentioned also show that presence of these symptoms are not dependent only on blockage of fluid. A number of patients with compression but no herniation have gotten relief from surgical correction of the hindbrain skullcase.

I think that a certain percentage of people with CFS, perhaps 20% as in the current studies, will turn out to have Chiari, perhaps more with the new definition of Chiari. I agree that it should be considered as a possible cause of symptoms. Be warned, however, that even when herniation is obvious, most radiologists and neurologists, and even probably the majority of neurosurgeons (the best choice) are inexperienced with either looking for Chiari or understanding how it works.



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