Arnold-Chiari Malformation
Effects of upper cervical subluxation concomitant
with a mild Arnold-Chiari malformation: a case study. Smith,
JL. Chiropractic Research Journal, 1997;4(2):77-81.
Note: Arnold-Chiari
(A-C) malformation is a variable congenital defect of the
brainstem originally described in 1894.
From the abstract:
This is the case of a 39-year-old woman with
complaints of intermittent bouts of fatigue, dizziness, facial
numbness, ataxia, headaches, difficulty speaking, and diffuse
arthralgias (pains) during the past two years.
She had already
undergone extensive medical testing which revealed a mild Arnold-Chiara
Type 1 malformation. Upon further investigation, it was decided
that the A-C malformation was an incidental finding, unrelated
to her symptoms. Medically, no solution or explanation of her
symptoms could be found.
The patient had an array of diffuse
symptoms, most of which could be explained neurologically by
the effects of an upper cervical subluxation.
Using the Grostic
method of upper cervical analysis, the authors measured an
occipito-atlanto-axial subluxation and managed the patient
using the Grostic procedure of hand adjusting for the upper
cervical region. Following the first and subsequent upper cervical
adjustments she experienced significant relief of her symptoms.
She has not felt the need to seek medical intervention since
beginning chiropractic care.
Chiropractic adjustment to the
cervical spine and the Arnold Chiari malformation. Murphy DR,
Goldstein D, Katz M Journal of Manipulative and Physiological
Therapeutics 1993;16:550-5.
Two cases of patients with Type
1 Arnold-Chiari malformation (ACM) received a series of chiropractic
spinal adjustments to the cervical spine. No ill effects or
complications were noted related to the ACM and ACM does not
seem to be a contraindication of specific cervical adjustments.
The
first case is a 37 year-old longshoreman who suffered neck
pain, headache, right shoulder and scapular pain and light
headedness, photophobia and blurred vision. The symptoms began
after a car accident. After 12 weeks of care he was completely
free from head, neck and scapula pain, lightheadedness and
visual problems also resolved.
The second case is a 36 year-old
internal medicine resident suffering from severe vertigo and
right arm pain. It appeared that her vertigo began after she
developed aseptic meningitis with labyrinthitis. Adjustments
were to C2-3. After 25 adjustments the arm pain resolved completely.
Her vertigo however did not resolve.
MRI of the Brain and Spine.
2nd Ed. Atas S.W. 1996. USA Lippincott-Raven
“...studies
of patients with Chiari I malformations in the future are likely
to focus less on the static anatomic appearance of the tonsils
in relation to the foramen magnum, but rather on the dynamic
motion of CSF (cerebro-spinal fluid), both in relation to physiologic
motion of the brain (brain pulsation) and in relation to the
mechanics of the craniocervical junction (flexion, extension,
rotation).”
Dr. Joesph J. Ierano, DC of NSW Australia
discusses the above:
“I would not presume that this comment
was intended to pertain to the chiropractic subluxation in
support of it. But it is interesting to note the reliance not
on appearance of cerebellar tonsils, but on the dynamic function
of the upper cervical area and CSF.
“This is why I believe
that upper cervical adjustment may improve symptoms of Chiari
Type I because the existence of subluxation affects the dynamic
function of this area and compromises brain stem and associated
nerves. Co-management remains the best option, (but try convincing
your local neurosurgeon of that).”
Copyright 2004 Koren Publications, Inc. & Tedd
Koren, D.C.