By Dr. Timothy Johnson
March 10 Tonight on 20/20 I am reporting on a fascinating cutting edge development in medicine that has the potential to affect millions of people.
I refer to the truly radical and controversial suggestion that some of the 5 million to 10 million patients who have been labeled with chronic fatigue syndrome and/or fibromyalgia may actually have a central nervous system abnormality that can be treated with surgery.
First some background. Chronic fatigue syndrome has been in the news for several decades as a diagnosis often applied to individuals who usually suddenly and mysteriously develop a constellation of symptoms that can include severe headaches, severe fatigue, confusion, and many other vague symptoms.
Similarly, fibromyalgia is a diagnosis applied to people who can develop similar symptoms but whose main complaint is muscle pain, often at specific tender points throughout the body. Unfortunately, we do not know the cause or causes of either of these problems and therefore we do not have predictably effective treatments. Over the years many causes have been suggested including the Epstein-Barr Virus but nothing has been proved to be the definitive cause.
Doctor Needs Treatment
Several years ago, a family physician from Dothan, Ala., Dr. Sam Banner, who was himself seriously impaired by chronic fatigue syndrome, learned of a neurosurgeon at the nearby University of Alabama in Birmingham, Dr. Michael Rosner, who was operating on patients who had symptoms very similar to his own.
However, this neurosurgeon knew nothing about chronic fatigue syndrome or fibromyalgia. He was operating on patients with the well known neurosurgical conditions called Chiari syndrome and/or cervical spinal stenosis, conditions in which narrowing of the opening at the base of the skull or in the neck were compressing the lower part of the brain or the spinal cord.
And he was doing the standard operation for these conditions removing bone in appropriate areas to enlarge the space for these critically important nerve tissues that are basically the pathway for all the nervous system from the brain to the rest of the body.
Surgery Helped Doctor
Dr. Banner ordered a MRI on himself and found that indeed he had narrowings of the same sort that Dr. Rosner was operating on. He showed them to Dr. Rosner who agreed to operate on him two days later. And that surgery led to a miraculous recovery for Dr. Banner!
Not surprisingly, both he and Dr. Rosner became fascinated by the possibility that at least some patients who had been diagnosed with chronic fatigue or fibromyalgia indeed had the classic neurosurgical problems that neurosurgeons had been operating on for decades.
So they started spreading the word and to make a long story short, Dr. Rosner, who now works out of Park Ridge Hospital, in Hendersonville, N.C., and Dr. Dan Heffez, a neurosurgeon in the Chicago Institute of Neurosurgery and Neuroresearch, have now operated on hundreds of patients with the diagnoses of chronic fatigue or fibromyalgia with dramatic results.
Before anyone jumps to inappropriate conclusions, I wish to stress the following:
1) The operations should be considered only for patients with abnormal neurological exams and abnormal findings on MRIs of the base of the skull and neck.Unfortunately, most patients with these problems are never examined neurologically given that the party line has been that chronic fatigue and fibromyalgia are probably caused by infections or immune system disorders.
2) This surgical treatment must definitely be considered experimental. It is too early to tell how long results will last and which patients might most benefit. The results from these neurosurgeons need to be published and examined by others. That has not yet happened.
But having said this, I am personally excited about the possibility that this surgery might help properly selected patients. I urge those of you afflicted with either chronic fatigue syndrome or fibromyalgia to watch our report tonight and see for yourself.