Chiropractic Functional Neurology: An Introduction
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…the spinal postural, cephalomotor, and extraocular muscles of the vestibulo-ocular reflex (VOR) all fatigue when they are constantly activated by the eyes constantly trying to regain a target. If the VOR is constantly activated because the eyes do not hold a target, this fatigues the nerves and muscles to the point of lactic acidosis and exhaustion, and extraocular muscle fatigue is a common source of head pain. The combined result is a patient with anxiety disorder and “migraine.” These are 2 examples of functional brain lesions not necessarily caused by ablative injury or disease.
The 2 cases in this issue of the journal demonstrate the effect that functional lesions can have on the nervous system. For example, Dr Swingen’s patient deteriorated to the point where she had to forego school and return home just to be able to rest and to hopefully recuperate. Although “rest” has historically been the main approach to concussion, today, greater emphasis is placed on active treatment to help the brain recover. In this case, the patient sustained damage to brainstem neurons where integration for gaze stability and for eye movements occurs. Neuron populations that control “pulse” and “step” activities that propel the eyes to a target and then hold the eyes fixed on that target all had to be retrained using finely tuned exercises directed at very specific neuron populations in the brainstem, cerebellum, and cortex that control these activities. With graded application of vestibular and ocular motor strategies, metabolic capacity of the nerves and muscles was restored, which can be seen in the posttreatment video nystagmography (VNG). A very important point to note here is that VNG findings are thought to be permanent and, thus, the ability to show changes on VNG is quite unique and remarkable. In the end, the unique exercises that produced the VNG changes also proved to be the key in the patient’s fast recovery once the correct therapies were introduced.
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