Improvement in achalasia following a neurological rehabilitation program: a case study
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1
Illinois Neuro and Physical Rehabilitation, United States
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2
Carrick Institute, United States
Background
A 32-year-old female patient presented to a functional neurology practice with complaint of achalasia that came on 10 years prior. The patient had previously used surgical intervention to manage the condition with some success, however, her condition began to worsen over the past several months before her visit. The patient presented with complaints of difficulty swallowing and digesting food. Barium swallow studies showed persistence of contrast agent in the esophagus after five minutes.
Methods
Neurological examination revealed left beating nystagmus. Pursuits had saccadic intrusions with eye movements up and to the right and down and to the left. The patient had decreased amplitude of optokinetics to the left. The patient had absence of her gag reflex and finger to nose was dysmetric on the right. The patient was diagnosed with achalasia. A treatment plan consisting of intense parasympathetic stimulation and brain-based therapy was implemented. The patient performed manual stimulation of the gag response, gaze stability exercises, complex movements of the extremities, and vibration exercises on the left side.
Results
The patient reported improvement in her ability to swallow and digest food. A follow-up barium swallow study showed the patient was able to clear the contrast in under one minute.
Conclusions
A patient scheduled for esophageal surgery finds relief through conservative neurological rehabilitation. Further research is suggested to investigate this approach in a larger population of achalasia patients.
Acknowledgements
Joseph Lawrence, Ralph DeStephano, Anthony Lemmo
Keywords:
Achalasia,
Parasympathetic Nervous System,
Neurorehabilitation,
conservative treatment,
Esophagus
Conference:
International Symposium on Clinical Neuroscience: TBI and Neurodegeneration, Orlando, Florida, United States, 10 Dec - 14 Dec, 2015.
Presentation Type:
Poster Presentation
Topic:
Case Reports for Poster Presentation
Citation:
Michalopoulos
G,
Talamantez
F and
Barton
D
(2015). Improvement in achalasia following a neurological rehabilitation program: a case study.
Front. Neurol.
Conference Abstract:
International Symposium on Clinical Neuroscience: TBI and Neurodegeneration.
doi: 10.3389/conf.fneur.2015.58.00016
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Received:
01 Nov 2015;
Published Online:
02 Nov 2015.
*
Correspondence:
Dr. Derek Barton, Carrick Institute, Cape Canaveral, FL, United States, derekabarton@gmail.com