The "meninges"; the sphnicer muscles; Parkingsons; and other problems…

[B]Drummer:[/B] You asked earlier in a post what the “meneges nerve” was – I think Bunny actually meant the [B][COLOR=”blue”]”meninges”.[/COLOR][/B] The reason I have heard of the meninges is because I have a disease called Chronic Adhesive Arachnoiditis (one of the meninges layers). I got the disease from a myelogram prior to back surgery in 1974. It was caused from the contrast dye used in the myelogray, called “Pantopaque”. The meninges are 3 special layers of tissue that surround and protect the spinal column and brain; the Dura, the Arachnoid, and the Pia (in order from scalp to brain). Their involvement with the brain is as follows (and I did not have this memorized):)

[B][COLOR=”blue”]Veins of Brain[/COLOR][/B]
The veins of the brain pierce the arachnoid and dura and open into the venous sinuses of the dura.

The superior cerebral veins drain into the superior sagittal sinus. The superficial middle cerebral vein follows the lateral fissure, sends superior and inferior anastomotic veins to the superior sagittal and transverse sinuses, respectively, and ends in the cavernous sinus. The inferior cerebral veins drain the inferior aspect of the hemispheres and join nearby sinuses.

The basal vein is formed by the union of several veins, including those that accompany the anterior and middle cerebral arteries. It winds around the cerebral peduncle and ends in the great cerebral vein.

The single great cerebral vein is formed by the union of two internal cerebral veins. It receives, directly or indirectly, a number of vessels from the interior of the cerebral hemispheres and also the basal veins. It ends in the straight sinus.

[B][COLOR=”Blue”]Venous Sinuses of Dura[/COLOR][/B]
The blood from the brain drains into sinuses that are situated within the dura mater and that empty ultimately into the internal jugular veins.

The superior sagittal sinus lies in the convex border of the falx cerebri. From its commencement near the crista galli, the sinus runs posteriorward and, near the internal occipital protuberance, enters in a variable manner one or both transverse sinuses. It receives the superior cerebral veins and communicates with lateral lacunae that contain arachnoid granulations.

The confluence of the sinuses (or torcular) is the junction of the superior sagittal, straight, and right and left transverse sinuses. It is situated near the internal occipital protuberance. The pattern of the constituent sinuses varies, and dominance of one side in drainage (e.g., the right) is usual.

The inferior sagittal sinus lies in the concave, free border of the falx cerebri and ends in the straight sinus, which also receives the great cerebral vein. The straight sinus runs posteriorward between the falx and tentorium, and joins the confluence.

The transverse sinuses begin in the confluence, and each curves laterally in the convex border of the tentorium, where it attaches to the skull. At the petrous part of the temporal bone, the transverse becomes the sigmoid sinus, which grooves the mastoid part of the temporal bone and traverses the jugular foramen to become the internal jugular vein. Smaller channels (petrosal sinuses) connect the cavernous sinus with the transverse sinus and jugular vein.

The cavernous sinus comprises one or more venous channels (sometimes a plexus). * It is located in a dural compartment bounded by the body of the sphenoid bone and the anterior portion of the tentorium. In addition to the venous channels, the dural compartment contains (outside the endothelium) the internal carotid artery, sympathetic plexus, abducent nerve, and, further laterally, the oculomotor, trochlear, and ophthalmic nerves. The cavernous sinus extends posterorly from the superior orbital fissure to the apex of the petrous part of the temporal bone. It receives several veins (superior ophthalmic, superficial middle cerebral, and sphenoparietal sinus) and communicates (by the petrosal sinuses) with the transverse sinus and internal jugular vein, as well as with the opposite cavernous sinus. The facial vein (via the superior ophthalmic vein) communicates with the cavernous sinus and hence allows infection around the nose and upper lip (“danger area”) to spread to intracranial structures.

Lateral lacunae are venous meshworks within the dura near the superior sagittal sinus, and both the lacunae and sinus occupy the granular pits of the calvaria. The lacunae receive (1) emissary veins, (2) diploic veins, (3) meningeal veins, and (4) occasionally some cerebral veins. It should be noted that the emissary veins, which pass through foramina in the skull, connect the deeper vessels with the veins of the scalp and hence also allow infection to spread from the scalp to intracranial structures.

And, by the way, meningitis is actually inflammation of [B][COLOR=”blue”]”the meninges”.[/COLOR][/B]

[B]Bunnyrarebit:[/B] My GBS also started with severe pain in my neck and shoulders…1st the left side, next day it spread to the right side too. Three days later in the evening after going to the doctor 2 days and the ER once, I still had the neck and sholder pain, and now could not urinate. When I tried go get up from the toilet my legs collapsed. My wife called the ambulance and I was admitted to the hospital but it took forever for them to insert a catheter, and when they did about 2 quarts passed. But I did not have any urinary infection and the pain continued in my neck and shoulders. In fact, because of my back history, they misdiagnosed me. They thought I had something wrong with my cervical spine. And because of that, I did not get any treatment of IVIg or plasmapheresis. But once I was relieved I had no problem urinating again. 3 days later I couldn’t breath, but the two neurologist treating me still thought it was my c-spine? Then I got Transverse Myelitis (unknown at the time), and the TM did severe damage to my sphincter muscles. I have control of my bladder and bowles, but I have dysfunctions in both.

[B]Zanna:[/B]
[QUOTE]Just back from appt with my neurologist and he said my hand tremors ,difficulty with swallowing ,the mild vibrations i get inside my body ,ringing in my ears are not related to gbs.[/QUOTE] It has been 13 years (Dec) since my onset of GBS…then to CIDP. I got my GBS from a flu shot, and as stated above, I did not get any treatment…was totally paralyzed. The only thing worked on my body was my eyelids, and that’s it! NOTHING…and that’s one hell of a feeling, with a tracheotomy and hooked to a respirator. But I should feel blessed that my eyelids worked, because that was how I communicated. For the past 13 years my ears have been ringing…24/7, the left worse than the right. It sounds like a warm summer night when the locust are in season…like when I was a kid on the farm and I could hear them in the fields and woods about 150 yards away. I never had a problem with my ears before GBS. I walk with a cane because I have never regained all my balance – maybe 70-75%. I never had a balance problem before GBS, and I doubt that you have Vertigo…just your balance from GBS too. I also have tingling in my hands/feet, numbness in parts of my legs, butt, and back. I have severe axonal damage, and anyone that has gone through axonal damage have many dead nerve cells, whose function is to communicate with other nerve cells. Without the help of the nerve cells, the neurotransmitters can not release the chemicals to support the muscle function, and without the help of this support the muscle must support itself. And as we get older the muscles get weaker because they do not have any reserve energy they may of had at one time, so the fatigue will become more noticable. That’a why fatigue will always be the no. 1 enemy of GBS/CIDPers. My hands/fingers also trimble a bit, and when this started about 4 years ago my neurologist thought I had MS or another attack of Transverse Myelitis (actually, that’s what MS is…multiple attacks), but a lumbar puncture did not show any Oligodendrocytes cells, but still showed an elevated protein count. I get regular treatments of IVIg. My last visit he noticed my chin quivering, and asked how long that had been going on?? My wife spoke up and said “about 2 months.” Now he thinks I may be in the early stage of Parkinson’s Disease.

The truth is, “we are in our own world – All of us with similar, but not exactly alike.” We share each others adventures because down deep inside, we are the only ones that truly understand how horribly one can feel with all the residuals, and what may trigger one of them, or several of them. I think we all know stress is not good for us, and as hard as it is at times, we need to keep our spirits high with a positive attitude. One thing I have learned over these last 13 years is that a strong spiritual and family love will restore, and uplift life more than anything else on this Earth.

Warmest regards to all.

Jethro