Resolution of Glossopharyngeal Neuralgia with Spastic Dysphonia following

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 4 th and 5 th 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.

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16 y. o. ? PIL?

Right lateral mass of atlas irritates CNIX when C 1 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 C 5, C 2 and C 1, 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