MULTIPLE SCLEROSIS

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HYPERBARIC OXYGEN THERAPY

The Background:

Oxygen is essential to every one of the tissues in the body and that any tissue injury requires oxygen for healing. Recent research in the University of Dundee has shown that, in the inflammation that is typical of MS, the transport of oxygen is severely limited by tissue swelling. It has been shown that, despite the blood flow increasing many times, there may be a severe lack of oxygen in the affected area so that, just when oxygen is needed most, it cannot reach the tissue in sufficient quantity.

Oxygen therapy, where the normal amount of oxygen in the air is many times exceeded, is now being widely used in medical practice, notably in the USA, Europe Japan, Russia and China primarily to treat carbon monoxide poisoning and aid the healing of injuries and wounds of different types. It is being used increasingly in neurological diseases such as stroke and in head and spinal core injury.

Its use in multiple sclerosis has been controversial, largely because its function and the expectations of its effects have been widely misunderstood. However, studies have shown that it is beneficial. The process by which damage to the nervous system is caused in MS clearly cannot be prevented by oxygen therapy, but, as already discussed, the body normally heals itself using oxygen from the air - giving additional oxygen extends the body's ability to heal and can limit some of the damage which the disease causes.

Why should this be? Breathing oxygen under pressure causes the dilated and leaky blood vessels in MS to constrict back to normal size and reduces the swelling, due to fluid gathering, which can lead to cells dying. Paradoxically, at the same time, more oxygen is delivered to the bloodstream so the net effect is to improve and accelerate the normal healing process. Drugs can also constrict blood vessels but, in doing so, they actually reduce the available amount of oxygen. It is obvious they cannot replace oxygen. The aim of oxygen treatment in MS is thus to minimise the amount of damage being caused, promote rapid healing and limit the scar formation which can prevent nerve function being restored. Clearly this is most appropriate as soon as possible after symptoms become apparent.

The main objectives of any useful therapy in the established disease is to limit further damage rather than expect to cure existing scars. Prevention is not only better but more realistic here, than cure, and, while there are many accounts of improvement or stabilisation in the variety of neurological functions by HyperBaric Oxygen (HBO) treatment in MS, it has been in bladder function that positive results have been most frequently described by researchers.

Measurement of bladder capacity and emptying have shown that oxygen treatment has a distinctly beneficial effect and a two year study at Glasgow demonstrated the importance of maintaining regular HBO treatment to prevent the progressive deterioration in bladder function commonly found with MS.

The value of such prevention of irreversible bladder nerve damage is measured not only in terms of comfort and well-being for an MS person, but also in the minimising of the tendency toward chronic bladder infection and the kidney damage which may have long-term consequences.

Oxygen Treatment

Availability and Provision.

HBO treatment is available at almost all Federation Centres. The equipment in the Centres is fully and regularly tested, maintained and insured. The equipment operators are comprehensively trained in its use. The initial course of treatment lasts for twenty days, with each session lasting one hour. Patients will sit together in a comfortable multiplace chamber. Pressure in the chamber will not exceed twice the atmospheric pressure (deep sea divers have experienced up to seventy times ambient pressure) and pure oxygen is breathed by face-mask.

After treatment a short rest with a cup of tea is recommended. Patients are monitored during the initial course and at its conclusion. After this, a regime for follow-up treatment is determined, ideally this would be once per week.

Remember, HBO is NOT a cure for MS. Whilst many MS people report improvements in their symptoms, the main aim is to stabilise the patient's condition and it has been shown that this can most often be achieved in the bladder function.

There are no side effects of the treatment, but before commencing a course confirmation that the patient's GP has no objection must be obtained and any physical condition other than the MS must be declared (e.g. it is essential that the ears can be cleared under pressure). During the last ten years well over a million treatment sessions have been carried out in this country alone without significant incident