Cranial therapeutic approach to cranial nerve entrapment part II: cranial nerve VII

Article Abstract:

The temporal bone is the skull bone which contains within it the facial nerve, the middle ear and ear ossicles (small ear bones), and the inner ear (the organ of hearing and balance). The facial nerve is important because it is responsible for controlling the voluntary muscles of facial expression, as well as for carrying nerves responsible for taste from the front two-thirds of the tongue and certain autonomic nerves as well. Whenever a chiropractor detects damage to the cranial nerves, the patient must be referred to a neurologist for diagnosis. Most tests of the integrity of the nerve involve examination of the patient's ability to move specific facial muscles, and testing of the patient's ability to taste. Palsy of the facial nerve is often manifested as a weakened ability to close or maintain closure of the eyes, or an inability to furrow one's brow. Injuries high in the path of the nerve involve the opposite side of the face, while injuries more distant along its complicated course affect functioning on the same side of the body. The detailed anatomic distribution and precise testing of the nerve are considered in depth. Although they are relatively rare, the differential diagnosis must exclude tumors associated with the eighth cranial nerve, the auditory nerve, and tumors of supporting cells of a deep brain structure, the pons (pontine gliomas). Bell's palsy is a common disorder of the facial nerve that results in facial paralysis on one side. This condition involves the loss of motor function, and any change in facial sensation is inconsistent with this diagnosis. The cause of Bell's palsy remains unknown, but a viral etiology is strongly suspected. Approximately 80 percent of these patients make spontaneous, complete recoveries in two to eight weeks. Invasion of the seventh nerve by herpes virus is termed Ramsay-Hunt Syndrome. It is associated with severe ear pain, and often with the presence of vesicles, fluid-filled blebs on the skin. Chiropractic treatment focuses on the temporal bone and its joint with the sphenoid (another skull bone), and is aimed at reducing ''tension'' among various anatomic parts. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Nervous system diseases, Facial nerve, Cranial manipulation, Neuralgia, Facial, Facial neuralgia

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Meralgia paresthetica and the superior popliteal space

Article Abstract:

Meralgia paresthetica is a nerve disorder which is associated with abnormal heat dissipations when evaluated by various thermal imaging techniques. The lateral femoral cutaneous nerve is a large, purely sensory nerve which is formed from fibers originating in the second and third lumbar nerves. The nerve runs from the lower back across the pelvis, and becomes cutaneous as it enters the front of the thigh. This nerve is responsible for conveying sensory impulses from the thigh back to the central nervous system. A small branch also carries sensory information from an area on the back of the thigh. A group of patients was examined for thermal dissipation (thermal gradients) along the course of this nerve. In some cases, this technique leads to the identification of neuropathies (nerve diseases) which could not otherwise be diagnosed. The technique can be used to quantify and measure changes in neuropathies that are in a rapid state of change. Several groups of patients were examined along the course of the lateral femoral cutaneous nerve and in the superior medial popliteal space (the somewhat diamond-shaped area behind the knee). In some cases, subtle changes in the thermal picture were found to correlate with various neurologic conditions. In the present study, 14 patients with meralgia paresthetica were examined. In 13 of these cases, an area of increased thermal emission was identified. Elevated emissions were demonstrated in patients in whom meralgia paresthetica was not suspected. Thermal variations are often small and can be easily overlooked; clinicians must exercise extreme care in assessing thermograms for evidence of pathology. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Medical thermography, Meralgia

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Orthopedic and neurological tests, signs, reflexes and maneuvers

Article Abstract:

There is a group of classical diagnostic tests and signs which are extremely useful in deciding which patients do not require surgery and can be treated by conservative chiropractic methods and which should be referred to conventional physicians. Unfortunately, some chiropractors misinterpret such tests and may try to make graded judgments on tests which are either positive or negative. Similarly, tests that indicate severe problems which short of divine intervention will never be changed by conservative therapy are used to assess the progress of this chiropractic therapy. Neurologic and orthopedic tests, signs and reflexes should only be used by the chiropractor to initially assess patients and decide on the need for referral, and should not be used to follow the progress of conservatively-treated patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Orthopedics, Neurologic examination

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