Wednesday, November 4, 2009

Case 1: Upper Cervical Care and Meniere's


CASE 1

by Michael T. Burcon, D.C.

HISTORY: This 87 year-old female suffered frequent episodes of vertigo, tinnitus and nausea for 45 years. She was in a moderate car accident a few years before onset. During episodes, she walked around her home holding onto the walls, trying to keep her head level at all times. She reported numerous falls over the years, some resulting in broken bones.

She was diagnosed with Meniere's disease at University of Michigan Hospital in Ann Arbor and Memorial Hospital in Chicago. She tried a variety of medications which would help her sleep, but did not help negate her symptoms. Surgical history of colostomy and right radical mastectomy noted. Four or five years prior to the onset of symptoms, she was a passenger in a car that rear ended another stopped vehicle while traveling approximately 45 mph.

EXAMINATION: Subject reported severe dizziness, blindness in the left eye, fullness in right ear, pain and stiffness of the neck and numbness in the left thumb. She was unable to lift her left arm above her shoulder. Exhibited limited range of motion with left lateral flexion and left rotation of the head. Edema was noted below the posterior base of the skull in the area of atlas.

Leg checks showed a 1" right pelvic positive and 1" left cervical syndrome. Modified Prill check elicited positive test for C1 subluxation. Cervical x-rays revealed narrowed disc spaces at multiple levels, particularly evident at C6-7. Minimal marginal spurring and bony overgrowth of facet joint margins. Atlas was subluxated posterior and inferior on the left articulation, under lapped on the right. Fifth cervical was inferior and posterior.

INTERVENTION AND OUTCOME: Immediately following specific atlas adjustment, subject reported complete alleviation of vertigo and dizziness. When she awoke the next morning, the tinnitus was also gone. She held the adjustment and was symptom free for two years. Cervical range of motion was improved.

After suffering a minor stroke, closely followed by three compression fractures caused by osteoporosis, the subluxation returned and a second adjustment was given. That adjustment has held for six months.

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