OBJECTIVE: To demonstrate the value of quantitative static perimetry, in research and practice of spinal manipulation therapy, by reference to the recovery of uniocular loss of vision.
CLINICAL FEATURES: A 44-yr-old housewife presented with nonspecific bilateral visual field loss. This visual disability disappeared immediate to pan-spinal manipulation under anesthetic. Later, on review, the presence of a uniocular visual defect was detected by quantitative static perimetry. Further examination revealed no pathology in the eye or brain to explain its occurrence, suggesting that it was due to microischemia of the optic nerve.
INTERVENTION AND OUTCOME: The uniocular scotoma recovered immediate to further spinal manipulation under anesthetic, only to recur on two further occasions, each time to disappear immediate to spinal treatment.
CONCLUSIONS: This case history demonstrates that spinal manipulation may dissipate microvascular spasm in the brain: even in branches of the carotid arterial system, which is not directly related to the spine. The author feels that the underlying pathology was interictal migraine, which is now known to produce prolonged hypertonic changes in the cerebral microcirculation; and he suggests that spinal manipulation is a treatment to be considered for interictal migraine.
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