The Effectiveness of Upper Cervical Chiropractic Care on Epilepsy
The Effectiveness of Upper Cervical Chiropractic Care on Epilepsy
The International League Against Epilepsy (ILAE) defines epilepsy as a disease caused by frequent abnormal and or excessive nerve activity in the brain.[1] There are two major types of seizures as defined by The Centers for Disease Control (CDC). These are generalized seizures and focal/partial seizures. While generalized seizures affect both sides of the brain, focal/partial seizures affect only one area of the brain.[2] Epilepsy is the most common condition which affects the brain. Among the common causes of epilepsy are low oxygen during birth, head injuries, brain tumors, genetic abnormalities of the brain, infections, stroke and abnormal levels of sodium, or blood sugar.[3] Other causes of seizures are missing medication doses, heavy alcohol use, and use of cocaine or other illegal substances, lack of sleep, and other prescribed and over the counter drugs which may counteract with seizure medications.[4]
Epilepsy and seizures can develop in any person at any age. 1 in every 26 persons will develop seizures in their lifetime. Seizures are more common in infancy. The incidence decreases after age 10 years. However after age 55, the rates of incidence increases as the geriatric population begin to experience strokes, brain tumors or Alzheimer’s disease. Seizures occur more among Hispanics. Caucasians are more often affected than African Americans.[5] Epilepsy is most commonly treated with anti-convulsant medications. Another treatment modality includes activation of the vagus nerve by surgical placement of a pacemaker along with medication.[6]
Another successful treatment modality for seizure management is chiropractic adjustments to the upper cervical spine which have proven to be an effective alternative in the treatment of epilepsy. The cervical spine known as the neck is comprised of seven (7) bones. The first two bones are C1 and C2. These are commonly known as the atlas (C1) and the axis (C2).[7] Together the atlas and the axis are known as the upper cervical spine. The atlas is a “resting place” for the base of the skull or the occiput during its mobility. The function of the axis is to act as a “pivot point” for the atlas. The atlas and the axis also collaborate to perform neck flexion, extension and rotation. The remaining cervical vertebrae, C3-C7 are known as the lower cervical spine. The lower cervical spine primarily functions to execute cervical lateral flexion.
There are three main adjustment techniques which have proven to be effective in the treatment of seizure activities; the Blair Analysis, Knee Chest and Side Posture Toggle adjustment techniques. The Blair technique was developed by Dr. William G. Blair DC who stated that C1 is non symmetrical. In order to determine asymmetry of the first cervical vertebra, leg length inequality and a series of upper cervical spine x-rays were analyzed.[8] In order to perform the knee chest technique, the patient’s chest is placed on the adjusting table while his or hers head is rotated according to the side of laterality while kneeling. Side posture toggle is performed with a quick thrust and release to the upper cervical vertebra while in the side lying position. The patient is positioned according to side of atlas or axis laterality.
Numerous researchers have investigated and proven that chiropractic adjustments are an effective treatment modality for seizure activity. In 2010 Dr. Hubbard and colleagues have proven the effectiveness of utilizing upper cervical techniques to treat epilepsy while treating a 25 year old woman.[9] She had been experiencing 1 to 2 seizures per month due to head trauma. Patient stated that she had been under chiropractic care previously but not been treated with upper cervical care. The type of upper cervical technique utilized on this patient was the Blair technique. This particular technique analyzes how the skull connects with the vertebral column. Patient was found to have a C1 misalignment. To correct this misalignment, she was placed on a side posture toggle table and given a Palmer Hole in One (HIO) toggle manipulation. The term HIO implies that a perfectly executed upper cervical adjustment would cause the vertebra be properly aligned. After 12 weeks of treatment, she reported having one seizure a few days after her first adjustment and after the series of treatments, there was no seizure activity.
Another success case is that of a two year old male patient who presented with seizure activity.[10] The onset of this patient’s seizures was following head trauma where he experienced 1 to 3 seizures per week. After a thorough case history, physical exam and chiropractic assessment, the patient was found have an atlas misalignment. The technique used in this case was the knee-chest. C1 lateralized to the right. He received the knee chest adjustment technique for the span of five and a half months for a total of seven visits. During each visit, he was evaluated for vertebral subluxation. After the first adjustment the child experienced increased seizure activity. However after continued upper cervical knee chest adjustments, his parents began noticing a gradual decline in seizure activity coupled with improvements in the child’s behavior.
Upper cervical chiropractic care has also proven to be effective in treating occipital lobe epilepsy in a nine year old female.[11] She presented for chiropractic care after being diagnosed by a Neurologist with uncontrollable left eye blinking with uncontrolled eye movements and fainting. The technique used to treat this patient was the Blair technique. The patient also had a thermal scan performed on the posterior cervical region with a Tytron C-3000. The Tytron C-3000 is an infrared technology.[12] The results of the thermography indicated neurological dysfunction. Prone leg checks revealed a right short leg by ¼ inch. X-ray analysis showed that upper cervical misalignment was evident. She had several upper cervical spinal adjustments using the Blair technique to the atlas to correct right laterality took place during the course of 5 months. After the first adjustment, her mother reported that her uncontrollable eye movements had improved significantly and leg length was equal. After the second month of care, the patient’s mother also reported that her right eye blinking had stopped completely.
The Blair technique has proven to not only treat seizure disorder but also bipolar disorder, sleep disorders and migraine headaches in a 23 year old female. While participating in sports, she sustained a head injury and developed several neurological abnormalities.[13] Her complaints continued over a 6 year period where she sought medical attention from several physicians. Evaluation by thermography readings and x-rays revealed that there was a misalignment in the upper cervical spine. After one month of care, there were no seizures or manic episodes reported by the patient. After 4 months of care, there were still no manic behaviors or seizure activity. In addition her migraines were decreased from 3 per week to 2 per month. After seven to eighteen months of upper cervical care, she was completely seizure free.
Correction of the atlas subluxation is also noted to play a role in seizure cessation.[14] A five year old Caucasian female suffered head trauma while at her daycare center. She began experiencing 10 to 30 episodes per day. Various laboratory tests as well as a CT (Computed Tomography) scan and MRI (Magnetic Resonance Imaging) were performed. Patient was prescribed Depakote, Zarontine and ACTH therapy. With this regime, the patient’s seizure activity increased to 30-70 episodes per day. Her communication skills were delayed and her reflexes were adversely affected. At this point, she sought upper cervical chiropractic care. Upper cervical x-rays were taken. X-ray analysis revealed a subluxation of the upper cervical spine. Her leg length was short by ¾ to 1 inch on the right. To correct the misalignment, patient was given a side posture toggle adjustment to the C1 transverse process on for three consecutive days. Immediately after the first adjustment, the leg length normalized but the seizure activity increased. On the second day, leg length was found to be ¼ inch short on the right. There were no seizures that day. On the third day, leg length was found to be 1/8 inch short on the right with no seizure activity. The patient’s parents also noted that she seemed more energetic and that there were postural improvements. Her parents were informed that her symptoms could reoccur. On the 17th day, the number of episodes increased to 100. However on the 27th day, seizure episodes had ceased completely resulting in decreasing of her medication doses. She remained seizure free for four weeks after her last visit and her speech also improved to five or six word sentences.
[1] International League Against Epilepsy. (2005). Retrieved September 25, 2015, from www.ilae.org
3 Lava, N. (2015, April 18). WebMD. Retrieved September 25, 2015, from Epilepsy.com: http://www.webmd.com/epilepsy/guide/epilepsy-causes
4 Lava, N. (2015, April 18). WebMD. Retrieved September 25, 2015, from Epilepsy.com: http://www.webmd.com/epilepsy/guide/epilepsy-causes
5 Schachter, S. S. (2013, July). Epilepsy Foundation. Retrieved September 25, 2015, from epilepsy.com: http://www.epilepsy.com/learn/epilepsy-101/who-gets-epilepsy
6 Beers, M. B. (1999). The Merk Manual . Merck Research Laboratories, Merck & Co., Inc. .
7 Windsor, R. (2013). Cervical Spine Anatomy: Overview, Gross Anatomy. Lippincott Williams & Wilkins.
8 Muncy, W., Forest, T., Hubbard, T. et al. (2005). Blair Upper Cervical Techique . 2nd ed.
9 Hubbard, T. C. (2010). Upper cervical chiropractic care for a 25-year-old woman with myoclonic seizures. J Chiropr Med , 90-94.
10 Komarek, A. T. (2015). Cessation of Seizures, Behavioral Disturbances and Improvements in Cognitive Developmental Dealy Following Upper Cervical Chiropractic Care in a 2 Year Old: A Case Report . J. Upper Cervical Chiropractic Research , 14-18.
11 Hopper, S. M. (2011). Upper Cervical Care in a Nine-Year-Old Female With Occipital Lobe Epilepsy: A Case Study. J. Upper Cervical Chiropractic Research , 10-17.
12 Uematsu, S. E. (1988). Quantification of Thermal Asymmetry, Part 1; Normal Values and Reproductibility. J Neurosurg, 552-555.
13 Elster, E. (2004). Treatment of bipolar, seizure, and sleep disorders and migrane headaches utilizing a chiropractic technique. J Manipulative Physiol Ther , 1-8.
14 Goodman, R. M. (1990). CESSATION OF A SEIZURE DISORDER: Correction of the Atlas Subluxation Complex. J. Chiropr Res Clin Invest, 43-46.
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