Transcript Glossopharyngeal Neuralgia Presentation

Resolution of Glossopharyngeal
Neuralgia with Spastic
Dysphonia following
Chiropractic Care to Reduce
Cervical Spine Vertebral
Subluxations: A Case Study
Michael Burcon, B.Ph., D.C.
Report findings:
04/22/2005 Complained to ENT of foreign body sensation in her throat.
10/21/2009 Upper GI showed previous Barrett’s esophagus.
05/29/2010 Awoke with intense throbbing pain on the right side of her neck. She
reported throat problems since 2001. Diagnosed with cysts on her vocal cords 3 or 4
years ago. Cervical x-rays showed marked degenerative spondylosis of the spine.
06/02/2010 Cervical CT examination showed possible unilateral Warthin’s tumor.
06/15/2010 Chronic right neck pain, spastic dysphonia involving right true vocal cord
and tingling in right arm and her 4th and 5th fingers.
12/21/2010 Transient ischemic attack producing jumbled speech.
05/11/2011 Significant difficulty speaking, cervicalgia and painful swallowing.
05/18/2011 Physical therapy did not help cervicalgia. Must be neurological in nature.
05/19/2011 ER MD: Evaluated multiple times by multiple specialties, none of which has
found a cause of right-sided throat pain. Had multiple procedures in multiple States.
May be from a pinched nerve in her neck.
Recommended MRI, but not able to have one.*
05/20/2011 Hurt dreadfully in anterior aspect of right sternocleidomastoid muscle when
asked to extend her neck. She could not say anything.
05/27/2011 Serendipitously, patient took double dose of Neurontin. Although it made
her sleepy and gave her a bit of unsteady gait, she felt a lot better, so dosage was
increased.
*Bilateral
stapectomies,
after waking up deaf
in one ear, then the other,
seven months apart,
at ages 30 and 31.
Win Free Tuition ($300)
12TH National Meniere’s Symposium
Saturday, June 23, 2012
Health Talk IV in morning
Check Patients in afternoon
Dinner Discussion in evening
Grand Rapids, MI ~ GRR Airport
16 y.o.?
PIL?
Right lateral mass of atlas irritates
CNIX when C1 misaligns Posterior
and Inferior on the Right
Medical Treatment
► Daily
prescriptions include Gabapentin
5700 mg (3600 mg maximum
prescribed by manufacturer, less for
geriatric patients), Lipitor 20 mg,
Hydrochlorothiazide 25 mg, Inderal 60
mg, Aleve, 220 mg, aspirin 81 mg,
Omeprazole 20 mg, Diazepam 15 mg,
Advil 800 mg, Hydrocodone 20 mg,
Benadryl/Lidocaine 40 ml and multiple
herbal and vitamin supplements.
Surgical Treatment
The annual crude incidence rate of glossopharyngeal
neuralgia per 100,000 population in Rochester, Minn.,
for 1945 through 1984, was 0.7 for both sexes
combined, suggesting that glossopharyngeal neuralgia
is a rare disease. There were no significant differences
between the sexes. (Mayo Clinic)
The incidence of glossopharyngeal neuralgia to
trigeminal neuralgia has been reported to be between
1:200 (Harris, 1937)
“However the glossopharyngeal nerve remains the neglected
cranial nerve. This is because the nerve is small and lies deep
within the neck, and surgeons often do not encounter the nerve
even with deep dissections of the neck. The nerve is not
commonly identified or visualised even when performing a
major neck operation, for example a radical neck dissection. A
more important reason is because the glossopharyngeal nerve
supplies important structures in the head and neck region only
in the company of another cranial nerve. It does not supply an
important structure in isolation and has no monopoly in the
innervation of any critical organ. Mother Nature had not
entrusted the glossopharyngeal nerve an important vital
function in the same way that she had given roles of
importance to the other cranial nerves. Never less,
Glossopharyngeal neuralgia can be life-threatening.” Soh KB.
The Glossopharyngeal Nerve, Glossopharyngeal Neuralgia and
the Eagle’s Syndrome - Current Concepts and Management,
Singapore Med J 1999; Vol 40(10)
Immediately after specific adjustments to C5, C2 and C1,
pain diminished from 10 to 1.
Tremor and head tilt were eliminated.
Eye clarity and facial color returned to normal.
She could talk normally.
Two days later pain was 0.
Six weeks later she was completely free
of seizure and pain medications.
She has sold her home in North Dakota and
moved to Grand Rapids, MI.
9/27/2011
9/29/2011