The Journal considers Case Reports to be the building blocks of evidence-informed practice. We accept they are 'n of 1' and find that rather than placing them low on the evidential hierarchy, it is this very characteristic that makes them compelling. A case report brings together the 'patient' and the 'practitioner' in a record of clinical decision making with outcomes.
It is the myriad of clinical observations documented and published by chiropractors as case reports that point to the knowledge-gaps that formal inquiry should be addressing as structured research.
Each paper published by the Journal offers the reader the ability to turn a clinical problem into an opportunity to improve Well-Being. Our attitude is to welcome your reports of practice so we can share them with chiropractors globally.
A 9 year old with Headache and Clumsiness: A question of ‘what next?’
Abstract: This ongoing case discusses a 9yo female patient known since birth to the chiropractor who presented differently to usual. The parent’s report provided valuable data that was not clinically evident. The recommendations to collimate a plain-film radiograph of the cervical spine to exclude the skull were over-ridden and a higher clinical yield provided information that led to the child being treated and then referred for further investigation. The specific learning outcome of this report relates to the value of practitioner experience and patient (including parental) input as powerful elements in evidence-based practice.
Indexing Terms: Upper Cervical, headache, copper beaten skull, chiropractic adjustment, vertebral subluxation complex.
Cite: Ierano J. A 9 year old with Headache and Clumsiness: A question of ‘what next?’ [Case Report] Asia-Pac Chiropr J. 2020;1:021 DOI https://doi.org/10.46323/2021021
Cranial optokinetic reflex and cervical dystonia
A 45-year-old female presented with acute cervical dystonic myotonic spasms and pain of two-day duration, unresponsive to acupuncture and physical therapeutic interventions. Initially her optokinetic reflex system was stimulated to increase dopamine activity related to specific left mesencephalic ocular stimulation. This required an optokinetic strip motion from the subject’s right upper visual field diagonally directed toward their left lower visual field. Directing the optokinetic strip on the diagonal was selected by the extraocular muscles innervation pathways. The selection of diagonal right upper to left lower optokinetic activation was specifically chosen to increase the activation and collateral stimulation of the ascending left mesencephalic reticular system and dopaminergic generating centers. This action was intended to regulate and modulate control through the left cerebral cortical-striatal pathways and through the descending medial longitudinal fasciculus to regain inhibitory balance to the output of her right cervical ventral horn cells. Completion of the intervention was determined when her symptoms were reduced by approximately 75%. Home exercises consisted of a download application of optokinetic strips into her iPhone with instructions to direct the optokinetic stimulus diagonally down and away from the side of cervical tension
Indexing Terms: cervical dystonia, cranial, optokinetic reflex, optokinetic strip motion
Cite: Pick M. Cranial optokinetic reflex and cervical dystonia [Case Report] Asia-Pac Chiropr J. 2020;1:021 DOI https://doi.org/10.46323/2021031