History: A 10-year-old girl was brought in to my office on 2-15-99 suffering chronic and severe migraine headaches. History reveals that this patient has been having migraine headaches 6 times a week for the past 3 years. At the current time, the patient has not been able to go to school due to the severity of the headaches. The patient was treated at Marino's Children's Hospital, where she recently saw a neurologist. Her pediatrician has prescribed Periactin Syrup as a preventative, however it has not been helpful. The patient does suffer mild allergies to mold and mildew. She did have a double hernia at 72 months, which required surgery. Past treatment for her headache, has included an illumination diet, prescribed by her pediatrician, which she has been on for the past 2 ½ years, however results have been extremely poor. It is noted that headaches do run on the paternal side of the patient's family.
Examination: Detailed examination was performed in our office revealing restricted range of motion of the cervical spine is noted. Palpatory tenderness of Cl / C2 on the left. There is also inflammation to the posterior cervical musculature. At the time of examination the patient did have a headache and stated that her pain intensity of her headache was a 10. There are also taunt and tender fibers of the posterior cervical musculature and the trapezium region bilaterally. Cervical x-rays taken in the routine weight bearing position and analyzed revealing an atlas listing of ASLP; decreased cervical lordosis, lower cervical subluxation and rotation of the upper thoracic vertebrae.
Care Plan: Recommendations were made for adjustments 3 times a week for 8 weeks and 2 times a week for 4 weeks due to the severity and chronicity of her headaches. At the end of that period she will be reexamined. If patient responds well to care, the care plan may be reduced pending patient's response to treatment.
Progress: The patient's symptomatology improved following her third visit at which time she stopped using the Periactin Syrup. She was advised to continue her treatment of 3 times a week. By the end of her third week, the patient was able to begin school again. She also started her dance classes for the first time in 2 years, and actually began to smile again. She was leading a normal and healthy life for a child of her age by the end of the 5th visit. Harley Bofshever DC, ICPA Newsletter, Nov/Dec, 1999