Saturday, March 29, 2014

Chiropractic Management of Children with Down Syndrome


Cranial therapeutic treatment of Down's Syndrome Chiropractic Technique.  Blum CL.Chiropractic Technique 1999; 11:66-76.
This is the case of a child born with trisomy X, suffering from failure to thrive, history of chronic pneumonia, tachypnea, fever and possible atrial septal defect. Medical professionals recommended open heart surgery but parents decided to investigate conservative care consisting of cranial therapy and nutritional therapy.  Many of the symptoms that the patient suffered were alleviated and the surgery was later cancelled.

Male Child - age 4 - Diagnosis: retardation, asthma, Down's syndrome, immune dysfunctionInternational Chiropractic Pediatric Association newsletter,  November 1996.
Patient had been evaluated at several clinics with retardation, asthma, Down's syndrome, immune dysfunction, and was on 11 medications on initial visit.  After 4 months of care, all medications were withdrawn and the above diagnoses were being changed.  Patient still under chiropractic care and very difficult to adjust - child does not want to lay or be on adjusting table - the patient is adjusted either in the mother's arms or on her back using the mother as a "table."  Adjustment: Atlas ASR, with a toggle type thrust.

Handicapped infants and chiropractic care: Down syndrome- Part 1.  McMullen M.International Chiropractic Association  Review Jul/Aug 90;46:32-35
Most infants with DS are found to exhibit subluxations of the atlas, axis or occiput, with cranial base faults being the next most common area of involvement.
Cases included a "fussy" DS baby who slept no more than 3-4 hours at a time. "The most dramatic, immediate change was in a 10-year old female DS with apparent encephalitic complications….immediately following her first adjustment (occiput/cranial base) she slept nine continuous hours (and has most nights since)…an improvement in her general muscle tone and the size of her head, which was growing at a disproportionate rate stabilized.
Infants with hypotonia had significantly reduced once care began; strabismus disappeared in all but two infants…previously chronic URTI/Otitis media was reduced. Dr. McMullen writes that if she can work on infants from their first few months of life, "It has been possible to reduce symptoms of craniofacial 'flattening.'  These infants have also developed normal palatal arch/length, which I feel has prevented the common trait of tongue protrusion as none of these children have been affected by this."

Studies reveal that10 to 20 percent of individuals with Down's Syndrome have radiographic Atlas/Axis instability. International Chiropractic Pediatric Association newsletter. May 1990.
10 to 20 percent of individuals with Down's Syndrome have radiographic Atlas/Axis instability defined as an anterior arch/odontoid distance greater than 4.5 mm.  Of these individuals, 10 to 20 percent have symptomatic spinal cord compression manifested as torticollis, spastic hemiparesis, paraparesis or quadriparesism, neurogenic bowel or bladder, paresthesias or abnormal gait with ataxia, staggering or clumsiness.

Upper cervical instability in Down's Syndrome: a case report. Dyck V. Journal of the Canadian Chiropractic Association 1981; 25(2): 67-8.
Although spinal manipulation is a safe procedure, the chiropractor should always be alert for contraindications to his treatment.

Down syndrome and craniovertebral instability.  Topic review and treatment recommendations. Brockmeyer D. Division of Pediatric Neurosurgery, Primary Children's Medical Center, Salt Lake City, Utah, USA.
"The diagnosis and management of occipital-atlantal and atlantoaxial instability in Down syndrome patients is a challenging problem in pediatric spine surgery."

Brachial plexus injury in an infant with Down's Syndrome; a case study.  Peet J. Chiropractic Pediatrics Vol 1 No 2 Aug. 1994.
This is the case of a 12 month male with Down's Syndrome who suffered a brachial plexus injury at birth.  The infant had a lack of upper body control and arm movement and had night time wakefulness which lasted several hours and which usually occurred more than once a night. Infant was unable to bring his hand or to mouth and sit up without support.
Chiropractic analysis revealed vertebral subluxations secondary to birth trauma.  While still in the hospital the parents were advised by the physical therapist and hospital staff to avoid chiropractic care. After the first adjustment the child began to sleep five to six hours at a time instead of two to three hours at a time.  By the third visit, the child could lift his arms for the first time in his life. He started to sit up six weeks after care.   Complete resolution of brachial plexus symptoms were achieved by three months.

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