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Category: Case Studies
Date 16-feb-1995
Case Title Monocular Scotomata and Spinal Manipulation: the Step Phenomenon
Author R. Frank Gorman, M.B.B.S., D.O.
Main Condition/ Disease  Visual Disturbance
Source Journal of Manipulative and Physiological Therapeutics (JMPT); Volume 19, No5, 344-49; (June 1996)
Abstract A case of a 62 year-old with a case history of microvascular spasm of the optic nerve, who developed a scotoma in vision in the right eye. The scotoma resolved after spinal manipulation. The author found significant recovery in vision occurring with each spinal manipulation treatment.
Summary In the introduction Gorman suggests that spinal manipulation can improve cerebral oxygenation, by reducing vasospasm. He cites critics as suggesting recovery of vision following spinal manipulation is a placebo affect, but he is confident (as am I) that this theory can be discounted as abnormalities in the eye only recover after spinal manipulation. In cases in which the vision disturbances are assumed to be psychoneurotic the subjects still have those same abnormalities after very long periods. This case reinforces SMT as the recovery event, as Gorman discusses the reoccurrence of the scotoma on three separate occasions and on each case following SMT, vision returned to normal. The manipulative methods included traction and rotary adjustment to the c-spine and thoracic spine manipulation. Visual sensitivity returns immediately after SMT. According to the author this case suggests “SMT can affect blood supply of localized brain tissue and microvascular abnormality of the brain is caused by spinal derangement.” Interestingly Gorman cites a study by Otte which found that 6 of 7 patients with non-traumatic cervical pain had “parieto-occipital hypoperfusion” and “in 24 patients confirmed by independent observers to be suffering from cognitive disturbances after whiplash ALL had parieto-occipital hypoperfusion compared to control subjects.” Parieto-occipital hypoperfusion basically means reduced flow of blood to the cerebral cortex in the brain. For us laymen it means the blood flow to part of your brain was not normal.
Keywords Vision, chiropractic, spinal manipulation, cervical spine

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