Ask the Experts Dr. Heiss

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Hi Everyone,

Here are answers back from Dr. Heiss. For those not familiar with Dr. Heiss,

he is at NIH in land.

1. When a patient has EDS, is there more scar tissue involved post op?

1. EDS (Ehlers-Danlos syndrome) is a rare condition in which the

connective tissue of the body is more elastic than normal because the

supportive protein, collagen, has reduced strength or is reduced in amount.

More scar tissue would be expected to form in EDS patients because their

collagen is weaker than normal and more scar tissue is necessary to provide

strength to bind the cut surfaces of a wound together after surgery. EDS

patients have increased mobility in their joints. Patients with EDS who are

considered for craniocervical decompression surgery should be evaluated for

possible instability at and around the craniocervical junction. Fusion

procedures are required in cases in which spinal instability is severe

enough to result in injury to the spinal cord. Because experts often

disagree, a second opinion at another medical center is strongly recommended

to confirm (or not confirm) the presence of this rare disorder.

2. 2. When a patient's body seems to vibrate inside, what is the

reason?

A A feeling of vibration inside the body is a strange symptom that may

not portend any harm if the neurological examination is normal.

3. 3. In the case of Chiari/Hydro with the reversal of the lordotic

curve, which occurs... Are there any symptoms that this curve reversal

itself can cause?

R Reversal of the lordotic curve is a sign of weakness of the posterior

neck muscles or decreased strength of the joints and ligaments in the

posterior (back part of the) neck. Symptoms of soreness or spasm of the

neck muscles can result.

4. Can CM patients SCUBA dive after being decompressed?

4. Patients with CM can SCUBA after being decompressed if they are

physically able to handle the rigors of SCUBA and if an MRI scan confirms

that the decompression has adequately expanded the CSF spaces at the foramen

magnum.