Elvis's Cause of Death Reexamined

[Matthew]

Scary that there are likely participants in this thread who will spout this nonsense to friends and family as excuses for Elvis' demise.

[Dan_T]

Head trauma can cause an autoimmune disorder, that much seems true. whether or not it had any affect on Elvis's health after his head trauma is unknown, but its possibility at the very least.

I've read that Elvis changed a little after that fall, but that may have been the way the Col' spoke to him in front of company.

I've read that they did observe and record "Head Trauma" during the Autopsy, and isn't that why Vernon thought Elvis had been murdered ?

I wouldn't rule out that it may have been a minor contributing factor.

[MountainMisst]

Medical News Today

What is a Concussion?

A concussion is defined as a complex pathophysiological process that affects the brain, typically induced by trauma to the brain. It can be caused either by a direct blow to the head, or an indirect blow to the body, causing neurological impairments that may resolve spontaneously. Symptoms usually reflect a functional disturbance to the brain, and may include physical (e.g., headaches, nausea), cognitive (e.g., difficulty with concentration or memory), emotional (e.g., irritability, sadness), and 'maintenance' (e.g., sleep disturbances, changes in appetite or energy levels) symptoms. A concussion is considered a brain injury.


Concussions Cause Long-Term Effects Lasting Decades

Damage to the brain caused by concussion can last for decades after the original head trauma, according to research presented at a AAAS (American Association for the Advancement of Science) Annual Meeting in 2013.

The finding comes to light at the same time as 4,000 former football players file lawsuits alleging that the National Football League failed to protect them from the long-term health consequences of concussion.

Concussion causes temporary loss of brain function leading to cognitive, physical and emotional symptoms, such as confusion, vomiting, headache, nausea, depression, disturbed sleep, moodiness, and amnesia.

However, even when the symptoms of a concussion appear to have gone, the brain is still not yet 100 percent normal, according to Dr. Maryse Lassonde, a neuropsychologist and the scientific director of the Quebec Nature and Technologies Granting Agency.

Dr. Lassonde previously worked alongside members of the Montreal Canadiens hockey team who suffered from severe head trauma, undertaking research into the long-term effects it can have on athletes.

Concussion Anatomy



She carried out visual and auditory tests among the athletes who suffered from concussion, as well as testing their brain chemistry, to evaluate the extent of damage to the brain after a severe hit.

The results indicate that there is abnormal brain wave activity for years after a concussion, as well partial wasting away of the motor pathways, which can lead to significant attention problems.

Her findings could have a considerable impact on the regulation of professional sports and the treatment of players who suffer from head trauma. It also highlights the need to prevent violence and aggression in professional sports.

Older athletes who suffered from concussion have symptoms similar to Parkinson's.

Among older athletes, the lingering effects of concussion are even more marked.

A recent study was carried out comparing healthy athletes to those of the same age who suffered from a concussion 30 years ago. The results showed that those who experienced head trauma had symptoms similar to those of early Parkinson's disease - as well as memory and attention deficits.

In addition, further tests revealed that the older athletes who had suffered from concussion experienced a thinning of the cortex in the same part of the brain that Alzheimer's affects.

Source: https://commons.wikimedia.org/wiki/File%3AConcussion_Anatomy.png

[MountainMisst]

As per article posted by Arvis - Hypogammaglobulinemia

Common Variable Immune Deficiency or “Late Onset” Hypogammaglobulinemia.

Common Variable Immune Deficiency (CVID) is a frequently diagnosed immunodeficiency, especially in adults, characterized by low levels of serum immunoglobulins and antibodies, which causes an increased susceptibility to infection. While CVID is thought to be due to genetic defects, the exact cause of the disorder is unknown in the large majority of cases.

Compared to other human immune defects, CVID is a relatively frequent form of primary immunodeficiency, found in about 1 in 25,000 persons; this is the reason it is called “common.” The degree and type of deficiency of serum immunoglobulins, and the clinical course, varies from patient to patient, hence, the word “variable.” In some patients, there is a decrease in both IgG and IgA; in others, all three major types of immunoglobulins (IgG, IgA and IgM) are decreased. In still others there are defects of the T-cells, and this may also contribute to increased susceptibility to infections as well as autoimmunity, granulomata and tumors.

To be sure that CVID is the correct diagnosis, there must be evidence of a lack of functional antibodies and other possible causes of these immunologic abnormalities must be excluded. Frequent and/or unusual infections may first occur during early childhood, adolescence or adult life. Patients with CVID also have an increased incidence of autoimmune or inflammatory manifestations, granulomata and an increased susceptibility to cancer when compared to the general population. Sometimes it is the presence of one of these other conditions that prompts an evaluation for CVID.

The medical terms for absent or low blood immunoglobulins are agammaglobulinemia and hypogammaglobulinemia, respectively. Due to the late onset of symptoms and diagnosis, other names that have been used in the past include “acquired” agammaglobulinemia, “adult onset” agammaglobulinemia, or “late onset” hypogammaglobulinemia.

Clinical Features of Common Variable Immune Deficiency

Both males and females may have CVID. In the majority, the diagnosis is not made until the third or fourth decade of life. However, about 20% of patients have symptoms of the disease or are found to be immunodeficient in childhood. Because the immune system is slow to mature, the diagnosis of CVID is generally not made until after the age of 4.

The usual presenting features of CVID are recurrent infections involving the ears, nasal sinuses, bronchi (breathing tubes) and lungs (respiratory tract). When the lung infections are severe and occur repeatedly, permanent damage with widening and scarring of the bronchial tree, a condition termed bronchiectasis, may develop.

The organisms commonly found in these sinopulmonary infections are bacteria that are widespread in the population and that often cause pneumonia (Hemophilus influenzae, pneumococci, and staphylococci) even in people who do not have CVID. The purpose of treatment of lung infections is to prevent their recurrence and the accompanying chronic and progressive damage to lung tissue. A regular cough in the morning and the production of yellow or green sputum may suggest the presence of chronic bronchitis or bronchiectasis.

Patients with CVID may also develop enlarged lymph nodes in the neck, the chest or abdomen. The specific cause is unknown, but enlarged lymph nodes may be caused by infection, an abnormal immune response or both. Similarly, enlargement of the spleen is relatively common, as is enlargement of Peyer’s patches which are collections of lymphocytes in the walls of the intestine.

In some cases, other collections of inflammatory cells, called granulomas, can be found in lungs, lymph nodes, liver, skin or other organs. These are largely composed of cells called monocytes and macrophages. They may be a response to an infection, but the cause is not really known.

Although patients with CVID have depressed antibody responses and low levels of immunoglobulins in their blood, some of the antibodies that are produced by these patients may attack their own tissues (autoantibodies). These autoantibodies may attack and destroy blood cells, like red cells, white cells or platelets. Although, most individuals with CVID present first with recurrent bacterial infections, in about 20% of cases the first manifestation of the immune defect is a finding of very low platelets in the blood or severe anemia due to destruction of red cells. Autoantibodies may also cause other diseases such as arthritis or endocrine disorders, like thyroid disease.

Gastrointestinal complaints such as abdominal pain, bloating, nausea, vomiting, diarrhea and weight loss are not uncommon in CVID. Careful evaluation of the digestive organs may reveal malabsorption of fat and certain sugars or inflammatory bowel disease. If a small sample (biopsy) of the bowel mucosa is obtained, characteristic changes may be seen. These changes are helpful in diagnosing the problem and treating it. In some patients with digestive problems, a small parasite called Giardia lamblia has been identified in the biopsies and in the stool samples. Eradication of these parasites by medication may eliminate the gastrointestinal symptoms.

Some patients with CVID who may not be receiving optimal immunoglobulin replacement therapy may also develop a painful inflammation of one or more joints. This condition is called polyarthritis. In the majority of these cases, the joint fluid does not contain bacteria. To be certain that the arthritis is not caused by a treatable infection; the joint fluid may be removed by needle aspiration and studied for the presence of bacteria. In some instances, a bacterium called Mycoplasma may be the cause and can be difficult to diagnose. The typical arthritis associated with CVID may involve the larger joints such as knees, ankles, elbows and wrists. The smaller joints, like the finger joints, are rarely affected. Symptoms of joint inflammation usually disappear with adequate immunoglobulin therapy and appropriate antibiotics. In some patients, however, arthritis may occur even when the patient is receiving adequate immunoglobulin replacement.

Finally, patients with CVID may have an increased risk of cancer, especially cancer of the lymphoid system or gastrointestinal tract.

Source: http://primaryimmune.org/about-primary-immunodeficiencies/specific-disease-types/common-variable-immune-deficiency/

[MountainMisst]

Scary that there are likely participants in this thread who will spout this nonsense to friends and family as excuses for Elvis' demise.

Dear Matthew -

Please open up and read with compassion and empathy.



There is more to it than what we were told by the MM (that is all)........ No-one is saying forget what they said, just, there is more to Elvis' history.

[fn2drive]

Head trauma = drug addict. Yep in the bizzaro world this is true. Former doctor who had his medical license revoked for being a drug pusher denies obviously addicted patient who consumed mass quantities of obiates daily took them-priceless. Back on earth, Elvis lived and died a drug addict because like the effects of drugs- see how simple that was. No need for bone cancer or head injury or terminal illness.

[Matthew]

Dear Matthew -

Please open up and read with compassion and empathy.

I get the joke "MountainMisst", no need to keep playin'!

[jurasic1968]

Did really Vernon believed his son was killed???? Oh, my god, if this is true this speak volumes about Vernon's own responsibility in the death of Elvis for doing nothing to save his son.

[epf]

Did really Vernon believed his son was killed???? Oh, my god, if this is true this speak volumes about Vernon's own responsibility in the death of Elvis for doing nothing to save his son.

I have experience very close to me with self destrucion. All one can do is worry to death and enjoy the good moments, it is really only up to the person to get help and cleaned up. If for some reason Elvis didn't manage or didn't want to manage, we have to respect Elvis and stop dancing on his grave.

Thanks Wiebe, i totally concur.

[fn2drive]

Did really Vernon believed his son was killed???? Oh, my god, if this is true this speak volumes about Vernon's own responsibility in the death of Elvis for doing nothing to save his son.

I have experience very close to me with self destrucion. All one can do is worry to death and enjoy the good moments, it is really only up to the person to get help and cleaned up. If for some reason Elvis didn't manage or didn't want to manage, we have to respect Elvis and stop dancing on his grave.

As a recovering addict you know better than most, step 1 is acknowledging the truth. No one is delighting in Elvis problems. They were very sad and robbed the world of his talent. But that doesnt mean the that he and he alone and not a trip and fall or anything else was the cause. And btw congratulations for casting your demon aside.

[jurasic1968]

Right. It's clear that Elvis was self destructing him. But Vernon. The Colonel and Doctor Nick are also to blame for his early death.

[epf]

Great reply, seaward. I too, think it was a mixture. There were numerous factors at play. Elvis was an accident waiting to happen.

[TCB-FAN]

Interview with Dr Nick.



EIN: When did Elvis’ drug issues become a concern to you?

11. Dr. Nick: Elvis returned to Memphis in 1973 with a medical emergency that was the result of a non-traditional medical treatment he had been undergoing for six months. That treatment caused him to become addicted to Demerol. After he was detoxed, Elvis’s system was never the same. He suffered permanent damage that impacted his health for the final four years of his life. I cover that incident thoroughly in my book because it is the basis for the hospital administration and staff jumping to the conclusion that Elvis was a drug addict.

12. Dr. Nick: Yes. We were told some drugs were there, so we checked it out and found them. The bottles were sealed and did not have a doctor’s name on them. They looked as though they had come from a pharmacy. We disposed of the bottles and Elvis never asked about them, as far as I know.

EIN: Such an incident very clearly highlights the dependency problem Elvis had with his prescription medications and the lengths he would go to ensure he had a supply of the drugs he wanted. Were there other incidents like this one?

13. Dr. Nick: No the incident does not “very clearly highlight the dependency problem Elvis had with prescription medications or the length he would go to ensure he had a supply of drugs he wanted” unless that is what a person wants the incident to show. It simply means to me there were drugs found in Elvis’s bedroom that someone told us had come from California. I understand there were others in Elvis’s entourage who acquired prescription drugs for him and took them with him. Many in his entourage have admitted that in their own books. It certainly does not mean that Elvis intended to take all the pills himself. Elvis was in the hospital at the time we found the pills, and he didn’t have those drugs in his system when we tested for them.

EIN: When did Elvis’ drug issues become a concern to you?

14. Dr. Nick: Elvis returned to Memphis in 1973 with a medical emergency that was the result of a non-traditional medical treatment he had been undergoing for six months. That treatment caused him to become addicted to Demerol. After he was detoxed, Elvis’s system was never the same. He suffered permanent damage that impacted his health for the final four years of his life. I cover that incident thoroughly in my book because it is the basis for the hospital administration and staff jumping to the conclusion that Elvis was a drug addict.

EIN: What was your treatment plan for Elvis?

15. Dr. Nick: The plan differed depending on what Elvis’s medical needs were at the time. There were specific treatments for specific issues.

EIN: Was Elvis’ problem with drugs worse when he was in Vegas, on the road or at home?

16. Dr. Nick: You need to read the book to understand that Elvis had health problems not an ongoing drug addiction problem as your question implies. The book explains in detail what illnesses plagued Elvis when he was in different parts of the country. When he was at Graceland, Elvis took a minimum of medication because he had less stress.

EIN: In 1973, Elvis overdosed twice on barbiturates, initially while in Las Vegas and later in St. Louis. Were these the first times Elvis had overdosed?

17. Dr. Nick: Your information above about overdoses is inaccurate. If you read my book, you will find an explanation for what really happened. I don’t respond to stories of situations I did not witness first-hand.

EIN: How did you respond to Elvis’ overdoses in 1973?

18. Dr. Nick: I didn’t treat Elvis for any overdoses in 1973. The term “overdose” is not how I would describe what Elvis experienced.

EIN: Elvis was known to be very stubborn when he wanted something. How aware were you that he was obtaining prescription drugs from other doctors?

19. Dr. Nick: I was not aware of what was taking place in California or Nevada when other doctors were treating Elvis. What people need to realize is that there were several people in the entourage involved in the acquisition and use of prescription drugs who in order to defend themselves made it appear that Elvis was the only one using them.

If he had taken the amount of drugs he’s been accused of taking, he could never have performed the rigorous schedule he did. It’s totally unrealistic to believe those rumours and it stuns me that people can still be that stupid after all these years.


Source: http://www.elvisinfonet.com/interview_drnick_2010.htm

Wonderful Q&A with Dr. Nick. Never seen that one. Thanks MM for the informative post !!

[TCB-FAN]

Some of who insisted Elvis was "on drugs" (prescription) were on hard drugs.

Elvis' friends in that position, did not have any medical background or further education to assist them to reason and think that there was more to the reason why, Elvis was feeling as he was.

As we know, Elvis' friends split into two groups who do not interact with each other: Those who were closer to Elvis, who shared a portion of their memories, who tried to give perspective and understanding on what happened to him. This closer inner circle shared their memories with Elvis' fans with empathy, reason, and in context, and perhaps, with gained medical knowledge (Elvis wanted the details of his illnesses to remain private), of which, is now being revealed (of course some of Elvis' friends shared a portion of these details decades ago).

The other group appeared to not place their memories in perspective when they retold their memories: To speak of Elvis' history in perspective, and with empathy - perhaps with 20/20 vision, (which would be nice) they should have enquired more, asked more, (perhaps they should have been told more, although if they sold information for money, of course they wouldn't have been told more) and basically, taken extra care to honour their best friend.

This is what those who love each other do. If someone changes, who is decent, caring, loving, generous, spiritual, thoughtful; one asks, "Why"?

Kindness.

Well put MM ! So sad how things unfolded the way it did. One would think something......just something would have been done to circumvent the end result, with all of the friends/family he had (inner circle and otherwise). Still puzzling to this day.

[dannyboy1]

Getting back to the original article at the head of this post...

The suggestion is certainly plausible, and answers the question of why.
We all recognize a decline from 1968,1969, so it is entirely logical to pinpoint a cause as the writer has done.

Some "fans" seem to gleefully revel in Elvis' weaknesses and addictions, happy to accept only the effects but refusing to consider a cause.
In reality the presence of the effect proves the reality of a cause.
The writer has done well in pinpointing a possible (and very plausible) cause.

[jurasic1968]

Sorry, but Doctor Nick it's not a credible or reliable source. He was another sycophant who took a lot of Elvis' money (the raquetball center courts company and the loans for his house that Elvis gave him for free!!!) And his book is absolutely ridiculous, written only for money after so many years.

[Scarre]

You're not bursting my bubble because you haven't proven anything, therefore your opinion is useless to me.

As a matter of fact, you have done nothing except repeatedly state your opinion in a rude manner without offering any further analysis. I would say that makes you a troll.

A troll? That what he keeps calling me
"Repeatedly state your opinion" is his middle name
Rude manners comes naturally.

Regarding the theory...unlike some "experts" here, I'm not a medical doctor.
Sure, it is plausible...but I think it's bull...

[Robert]

Elvis decline may have been caused by a combination of factors.
Drug dependency based on a variety of medical problems? A fact for sure.
Drug addiction without a medical need? no question about it.
The head trauma theory can't be ruled out. It may have contributed but it's hard to prove after all these years.
But no one on this board will be able to confirm or deny the theory behind this.

[poormadpeter2]

I'm not sure why, after forty years, any of this matters. Even if Elvis was found to have died from something completely unrelated to drugs (which I don't believe for a minute), it wouldn't matter. The drugs-as-cause-of-death story is out there now and has been for decades, and nothing is going to change that from being what is written down in history. Elvis took drugs, he abused drugs, and he knew he was doing it. He nearly died from doing so on more than one occasion prior to his death in 1977. Trying to come up with some cock-a-hoop weird and wonderful tale that something else was the main reason for his desire is, frankly, bonkers.

On a straightforward practical note. You can't re-examine a death in this way without re-examining a body.

[Arvis Paisley]

I think some of the people are missing the point of this. It's not a conspiracy theory or an attempt to write drugs out of Elvis's story. It doesn't attempt to prove that drugs were not a contributing factor to his death. But a lot of people are treating this article as if it is and does those things.

What it does is attempt to provide a plausible explanation of why Elvis took more drugs and had personality changes after his head injury. No one here is taking what this doctor says as gospel. We are just weighing the information.

[rjm]

For a long time, I also felt Vernon was "to blame" in the sense that he wanted to believe that his boy, his only child, the light of his life could not have been an addict. He wanted to believe it. Doesn't mean he did believe it, but it hurt him and that hurt stood in the way of action.

I no longer blame him. You can only do so much, and then it really is the responsibilty of the addict. That applies even if the addict were still a teen - it always rests on the shoulders of the person in danger to really want to seek assistance. And he didn't want to. Who tried harder than Cissy Houston? No one I know, but she couldn't save her. As for causes, I have my own ideas about that - and no need to share that since we really aren't doing a psychological autopsy here. It might be of interest to a psychologist to take that on, though.

For us, this is the ONLY resource:

..

rjm

[midnightx]

Sorry, but Doctor Nick it's not a credible or reliable source. He was another sycophant who took a lot of Elvis' money (the raquetball center courts company and the loans for his house that Elvis gave him for free!!!) And his book is absolutely ridiculous, written only for money after so many years.

He violated his professional ethics and duties, and failed Elvis and his profession. He was disgraceful.

[poormadpeter2]

I think some of the people are missing the point of this. It's not a conspiracy theory or an attempt to write drugs out of Elvis's story. It doesn't attempt to prove that drugs were not a contributing factor to his death. But a lot of people are treating this article as if it is and does those things.

What it does is attempt to provide a plausible explanation of why Elvis took more drugs and had personality changes after his head injury. No one here is taking what this doctor says as gospel. We are just weighing the information.

For goodness sake, the injury was not serious. Hundreds of thousands of people get a knock on the head and do not then go off and start taking drugs for the next ten years. He did it because he wanted to. End of story.

[fecc-mechanic]

Medically speaking, the theory holds very little water. I'll always be the first to say "anything is possible".

However, the etiology of the disorder isn't described accurately in the article. Dr. Tennant cherry-picks symptoms that fit, and conveniently leaves out others that do not. Certainly not the expected behavior of a diagnostician/clinician of Dr. Tennant's usual impeccable stature.

It also takes a lot more than a mild/moderate blow to the head (which to cause the action described would have to almost certainly involve a massive open skull fracture). Such a fracture never occurred. A concussion, did. The mechanism of injury in Elvis' case, again, does not adequately account for what Dr. Tennant claims occurred.

With that said, there is an inherent genetic involvement,for certain, on Elvis' maternal side of the family... But not in a new and earth-shattering manner.

Edited to say: I've added some further thoughts, above and below. The above post was written after being awake for wayyyy too long. So some fixes had to be made.

Anywho... Reading "between the lines" of the various articles that have been published ---------- it almost seems like Dr. Tennant is trying to give Elvis the primary diagnosis of a Centralized Pain Syndrome (CPS), without necessarily coming right out and saying so. In some, the CPS diagnosis is secondary to the auto-immune disorder, in others it is primary. It is hinted in some of the articles more strongly than others... While the only treatment algorithm for such a disorder (then, and still now) is massive amounts of opiate pain meds - and even then, such meds are hardly effective in treating the pain ---- Elvis most certainly did not suffer from such a disorder. What differs from a normal chronic pain diagnosis - is that there is no "fixing" it by traditional means, only managing the symptoms over the course of a lifetime. Very little is known about CPS, still, but enough is known to know that it is a highly unlikely fit in EP's case. Phantom Limb Pain (Though, not necessarily falling under the CPS umbrella) experienced by amputees is a good descriptor of the type of neurological mayhem that CPS patients go through. While PLP is transient, CPS is almost always life-long.

Generally speaking, CPS is triggered by a handful of events. Parkinsons, MS, Malignant/Non-Malignant brain tumors, and massive brain and/or spinal cord injuries. It again must be re-iterated that the type of brain injury spoken of is the type of brain injury one experiences from a significant traumatic even (Automobile crash with open/closed head injury, blunt force from a fall of a minimum of 15feet, getting beaten about the head with a baseball bat, etc). As in Elvis' case, a concussion (or even 100) with absolutely no significant associated structural trauma or cerebral edema WILL NOT account for, or lead to a CPS diagnosis.

Dr. Tennant hints at EP suffering from Centralized Pain Disorder in the below article:

http://www.practicalpainmanagement.com/pain/other/brain-injury/elvis-presley-head-trauma-autoimmunity-pain-early-death

"...stemmed from multiple head injuries that led to an autoimmune inflammatory disorder with subsequent central pain. His terminal event was cardiac arrhythmia, underpinned by drug abuse".

Of note, regarding hypogammaglobulinemia which Dr. Tennant states as significant in almost all of the articles ----- notice the addition at the bottom of this image from the above article:


The significance is that the post-mortem sample (With 1970's tech) can certainly raise the question of hypogammaglobulinemia - If the sample showed a significantly decreased level of immunoglobulin-A, Immunoglobulin-M, and Immunoglobulin-G. However, Elvis' levels were within normal range. Dr. Tennant tries to say that since they were within the "lower limits of normal" that these findings are significant. They are not. And they are not "Consistent with a chronic disease state".

That would be like saying someone with a sodium level within the lower limits of normal is suffering from hyponatremia... Doesn't work that way.

[MountainMisst]

Medically speaking, the theory holds very little water. I'll always be the first to say "anything is possible".

However, the etiology of the disorder isn't described accurately in the article. Dr. Tennant cherry-picks symptoms that fit, and conveniently leaves out others that do not. Certainly not the expected behavior of a diagnostician/clinician of Dr. Tennant's usual impeccable stature.

It also takes a lot more than a mild/moderate blow to the head (which to cause the action described would have to almost certainly involve a massive open skull fracture). Such a fracture never occurred. A concussion, did. The mechanism of injury in Elvis' case, again, does not adequately account for what Dr. Tennant claims occurred.

With that said, there is an inherent genetic involvement,for certain, on Elvis' maternal side of the family... But not in a new and earth-shattering manner.

Edited to say: I've added some further thoughts, above and below. The above post was written after being awake for wayyyy too long. So some fixes had to be made.

Anywho... Reading "between the lines" of the various articles that have been published ---------- it almost seems like Dr. Tennant is trying to give Elvis the primary diagnosis of a Centralized Pain Syndrome (CPS), without necessarily coming right out and saying so. In some, the CPS diagnosis is secondary to the auto-immune disorder, in others it is primary. It is hinted in some of the articles more strongly than others... While the only treatment algorithm for such a disorder (then, and still now) is massive amounts of opiate pain meds - and even then, such meds are hardly effective in treating the pain ---- Elvis most certainly did not suffer from such a disorder. What differs from a normal chronic pain diagnosis - is that there is no "fixing" it by traditional means, only managing the symptoms over the course of a lifetime. Very little is known about CPS, still, but enough is known to know that it is a highly unlikely fit in EP's case. Phantom Limb Pain (Though, not necessarily falling under the CPS umbrella) experienced by amputees is a good descriptor of the type of neurological mayhem that CPS patients go through. While PLP is transient, CPS is almost always life-long.

Generally speaking, CPS is triggered by a handful of events. Parkinsons, MS, Malignant/Non-Malignant brain tumors, and massive brain and/or spinal cord injuries. It again must be re-iterated that the type of brain injury spoken of is the type of brain injury one experiences from a significant traumatic even (Automobile crash with open/closed head injury, blunt force from a fall of a minimum of 15feet, getting beaten about the head with a baseball bat, etc). As in Elvis' case, a concussion (or even 100) with absolutely no significant associated structural trauma or cerebral edema WILL NOT account for, or lead to a CPS diagnosis.

Dr. Tennant hints at EP suffering from Centralized Pain Disorder in the below article:

http://www.practicalpainmanagement.com/pain/other/brain-injury/elvis-presley-head-trauma-autoimmunity-pain-early-death

"...stemmed from multiple head injuries that led to an autoimmune inflammatory disorder with subsequent central pain. His terminal event was cardiac arrhythmia, underpinned by drug abuse".

Of note, regarding hypogammaglobulinemia which Dr. Tennant states as significant in almost all of the articles ----- notice the addition at the bottom of this image from the above article:


The significance is that the post-mortem sample (With 1970's tech) can certainly raise the question of hypogammaglobulinemia - If the sample showed a significantly decreased level of immunoglobulin-A, Immunoglobulin-M, and Immunoglobulin-G. However, Elvis' levels were within normal range. Dr. Tennant tries to say that since they were within the "lower limits of normal" that these findings are significant. They are not. And they are not "Consistent with a chronic disease state".

That would be like saying someone with a sodium level within the lower limits of normal is suffering from hyponatremia... Doesn't work that way.

Hi Jordan

...