Meniere's Disease: Discussions and Conclusions

by Michael T. Burcon, D.C.

All three Meniere's patients had a history of an automobile accident. All three showed evidence of upper cervical subluxation upon neurological examination, and all exhibited both evidence of a history of whiplash and an existing atlas subluxation in radiographs. All three had posterior and inferior left atlas listings.

It is possible that the anterior tubercle of atlas is irritating the nerve root of CN VIII as it exists from the upper lateral portion of the medulla oblongata, just anterior to the midline of the brain stem. Two patients reported that their ear problems were predominately on the right, the third case was bilateral. If atlas subluxates to the left, it could apply pressure on the right nerve root.

Medical research has established a connection between spinal trauma and numerous neurological conditions besides Meniere's disease, including Multiple Sclerosis, Parkinson's disease, Amyotrophic Lateral Sclerosis, Trigeminal neuralgia, epilepsy and migraine headaches.

Physicians often make the mistake of thoroughly examining only the area of chief complaint. When relevant, I believe it is prudent to start at the nucleus of the cranial nerve or center that supplies function to that area. For example, the brain stem, for balance disorders(CN VIII), irritable bowel syndrome (CN X, Vagus), high blood pressure (vasomotor center) and sleep disorders (reticular formation).

CONCLUSION

A case study is limited in its ability to provide conclusions. It is possible that the patients recovered through spontaneous remission or because they believed their problems had been discovered and improved, creating a placebo effect. The time span before chiropractic intervention and the long-term, clinically documented, neurophysiological improvements after initial adjustments weigh against these affects.

All patients with a history of vertigo and/or dizziness should be questioned about a history of trauma, especially whiplash from an automobile accident, contact sports injury, or serious falls, etc. Patient often forget these accidents, thinking that they were not hurt because they did not break any bones and were not bleeding. Patients with a history of both should be referred to an upper cervical specific chiropractor for examination.

Case 3: Upper Cervical Care and Meniere's Disease

CASE 3

by Michael T. Burcon, D.C.

HISTORY: Thirty five year old female presented with history of vertigo, swallowing difficulties, nausea, cervicalgia, cephalgia, double vision, occasional deafness, weakness and fatigue since 1996. She was working part-time out of her home, unable to drive or go anywhere. She reported having a minor car accident in 1991.

Diagnosed with Meniere's disease, TMJ dysfunction, rheumatoid arthritis and Arnold-Chiari malformation. Prescriptions included Duricef, Retin-A, Benzymicin and Antivert. Her father had been diagnosed with Becker's muscular dystrophy.

EXAMINATION: Leg checks demonstrated 1" right pelvic negative, 1" left cervical syndrome and positive C1 and C5 tests. Restricted range of motion with left lateral flexion. X-rays, video fluoroscopy and MRIs showed atlas to be inferior and posterior on left articulation, under lapped on the right, and inferior and posterior C5 and C6. Thermograph showed pattern of a break to the left at levels of C1 and C5.

INTERVENTION AND OUTCOME: Within 24 hours of first specific atlas adjustment, all symptoms had subsided, except dysphagia, which had gotten worse. All balance tests were negative and cervical thermograph was straighter. Full cervical range of motion was restored.

Atlas adjustment has been repeated when pattern of subluxation has returned, a total of six times in the past two years. The swallowing problem has persisted.

Case 2: Upper Cervical Care and Meniere's Disease

CASE 2

by Michael T. Burcon, D.C.

HISTORY: Fifty seven year old female diagnosed with Meniere's disease in 1991. Onset was sudden and severe. She reported being paralyzed for a short time. Following this episode, she gave up driving. She was a passenger on a bus that was in a relatively serious accident in 1975.

Symptoms were relieved for two years by endolymphatic shunt surgery. Recent test revealed 50% hearing loss in right ear. Symptoms were currently returning most mornings and lasting into the afternoon. They were relieved by diet pills, valium and bed rest. She decided to try chiropractic as an alternative to a second shunt surgery.

EXAMINATION: Patient reported dizziness, nausea and stiff neck. Leg checks demonstrated ¾" right pelvic negative, ¾" right cervical syndrome and positive C1 test. Limited range of motion of cervicals bilateraly. Cervical thermograph showed right break at level of C1. X-ray analysis revealed atlas subluxation to be posterior and inferior on the left articulation, under lapped on the right.

INTERVENTION AND OUTCOME: After specific atlas adjustment and rest, patient was post checked. She was balanced, all tests were negative and all symptoms were gone. Cervical range of motion was restored. Cervical thermograph was straight. After one year, patient is holding adjustment and symptom free.

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.

Upper Cervical from the Specific

This is great information about Upper Cervical Care from the website www.thespecific.com. I have also added a link to their site on the sidebar of this blog.

Specific Chiropractic is not about getting adjusted or even receiving adjustments; it is about living a life free of nerve interference. In fact, our goal in care is actually to deliver as few adjustments as possible.

Upper Cervical Specific Chiropractic Care focuses on removing nerve irritation to restore communication between the brain and the body. Restoring function at the level of the brainstem and upper cervical spine (the control center of the body) is essential so that the body may heal itself and have optimal vitality. With the nervous system functioning at 100% the body has the potential to heal itself from even the most complex of ailments.

The words "Upper Cervical" refer to the first two bones in the neck. They are very unique vertebrae, vastly different than the other 23 bones comprising the spinal column. In fact, they have special names. While most people understand the common letter and number system for the vertebrae of the spinal column, the first bone has a particular name, The Atlas. The second bone is referred to as The Axis. These two vertebrae are the only two vertebrae between which there is NO DISC. The absence of the intervertebral disc allows for a greater range of motion. Because of this increased range of motion, these segments are much more likely to misalign, causing nervous system interference at the level of the brain stem. The misaligned segments are identified through the use of Digital Laser-aligned Radiography. Because the misalignment is very slight (measured in millimeters) it is very important that precise x-ray equipment is used.

This nervous system interference can be detected through the use of Computed Infrared Thermography. Thermography has been used for thousands of years to diagnose the sick. In modern times new medical breakthroughs have allowed us to further understand the link between thermal imbalances and nervous system dysfunction. For this reason we utilize thermographic scans both pre- and post-adjustment. It is of absolute importance that the patient understands that results do not come from the adjustments themselves, but rather from the patient achieving a healthy and fully functioning nervous system. For that reason, we utilize thermography to indicate when nervous system interference is present, and therefore, whether or not the patient needs an adjustment. Furthermore, thermography is utilized post-adjustment to be sure that the proper adjustment has been made and that nervous system interference has been reduced or eliminated.

Finally, an Upper Cervical Specific Adjustment is made to the misaligned segments. This is a quick, impulse-type thrust applied to the upper part of the neck. It is safe for patients of all ages. We have experience applying the adjustment to patients ranging in age from 1 day to 95 years old! After the adjustment, the patients will enter a post-adjustment recuperation suite where the patient is placed in a recumbent position for approximately 20 minutes to allow the body to accommodate the adjustment and allow for a longer holding adjustment. Following the post-adjustment recuperation, the patient is scanned with the infrared thermography one last time before going home.

Upper Cervical Corrections by Hand or Instrument?

I think this is a fair assessment of the question above.

HOW GREAT IS THY ART?
Cecil D. Laney, D.C.

Chiropractic is a philosophy, science and art. The philosophy is our core beliefs which maintain that optimum nerve function is vital to good health and that the nerve function can have interference and this interference can be removed.

The science is the mathematical determination of the structural integrity of the human body. It also addresses the postural standards as to what is normal and optimum to achieve normal nerve function.

The art is the skill with which we render service to the patient in restoring nerve function in the pursuit of better health.

Without data, everything is just an opinion. Therefore, I will offer opinions after over 50 years of observation. I am saying that our greatest failure has been our poor achievement in the art of chiropractic.

Someone estimated that there are over 150 different techniques in the country. I think that there are really two major procedures, the manipulators and the specific adjusters. There is a difference. To manipulate, you move structure randomly. To adjust, you move structure from a given place to a different given place. Unfortunately, the vast majority of chiropractic practices consists of manipulation.

The time is here when the powers that be, the government, insurance companies, etc. are asking: "What do you chiropractors do?" Our answer is: "We correct spinal distortions." But do we? Can you prove it? Do you take pre and post x-rays? If not, what is your method of evaluation?

Dr. B.J. Palmer said the subluxation can only exist in the cervical area. My experience leads me to agree with him. In this area, palpation and postural observation are helpful, but the only reliable performance monitoring method is precision pre and post x-rays. This is the only method I accept.

I have heard claims of everything up to 100% on nearly all cases. I have yet to see proof of this kind of performance. Dr. John D. Grostic told me his father had about 87% overall average correction. This was a surprise to me in view of the fact that adjusting me, he hit 100% almost every time.

It doesn't tell us much if you show a case of 100% correction, but it will give a picture of your performance if you show a dozen consecutive cases with close proximity dates on the film.

In discussions with some of our best hand adjusters, I have come to the conclusion that their overall average is in the nature of 50%. This is good, a far better performance than the manipulators. It is about twice as good as I was ever able to do. I applaud anyone who is training themselves to hand adjust. Maybe someone will come up with a modification of the procedure that will make it more doable.

My observation is that an average 50% correction will eventually build a referral practice even if the doctor has a sour disposition. A 70% average correction will build you an overflow practice.

We are entering a new era in the art of chiropractic. I have designed, built and delivered to Life University a new table mounted cervical adjusting instrument, giving them all rights to it. It has functions that to my knowledge, has never been utilized before. It is being evaluated in the Research Department. We expect to achieve 80 to 90 percent average corrections. This kind of performance will make miracle cases commonplace. The instrument uses the Grostic analysis and adjusting vectors. We urgently need for it to be placed in a few Grostic proficient doctors' offices to accumulate data.

If my opinion is wrong and you can document a correction performance of 70% or above, I want to be a student of yours. If you are averaging much less than 50% with hand adjusting, I would recommend you move to the use of adjusting instruments. It is not fair to your patients to do otherwise.

Parkinson's Disease, Meniere's Syndrome, Trigeminal Neuralgia and Bell's Palsy

by Michael T. Burcon, DC
Abstract

I currently have 16 Meniere's syndrome, two Parkinson's disease, two Trigeminal neuralgia and two Bell's palsy patients under my care. They all have one thing in common: The atlas vertebra is subluxated posteriorly, which has caused the head to project forward, taking away the healthy curve of the neck.

In each patient, the pelvis has twisted to take pressure off the important nerves in the upper neck and brainstem, causing one leg to appear shorter than the other; normal lumbar curvature is compromised; and finally, if not specifically adjusted, the patient compensates by developing an exaggerated curve in the thoracic spine.

I hypothesize that in each patient, kink(s) in the neck inhibited the normal flow of cerebrospinal fluid out of the skull and down the spine; this created excess pressure in the fourth ventricle, causing abnormal function of some of the structures in the midbrain. It also inhibited the flow of blood into the occipital area of the brain by kinking one of the vertebral arteries. Additionally, I suggest that the posterior atlas irritated the anterolateral aspect of the brainstem, irritating any combination of the bottom seven cranial nerves.

All 22 patients improved dramatically after one or two adjustments under cervical-specific chiropractic care. When the atlas returns to juxtaposition, the spinal cord relaxes and actually positions itself lower within the spinal column.