Specific clinical neurological treatment for illiteracy and oculomotor dysfunction
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1
Georgia Chiropractic Neurology Center, United States
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2
Life University, United States
Background:
An 11-year-old boy with 20/20 vision presented to a chiropractic neurology center for the chief complaint of difficulty reading and writing. Whilst reading, the patient tended to skip words in a sentence, he was unable to accurately read consecutive lines going down a page and had difficulty reading aloud. The patient’s handwriting was illegible. Two years prior, an optometrist had diagnosed him with accommodative dysfunction and convergence insufficiency from whom he also sought care. There he received traditional eye exercise therapies which were ineffective.
A neurological exam revealed mild breakdown of alternating pronation and supination of the upper extremity. Decreased gain (average = 0.9) and saccadic intrusions during pursuit testing were evidenced in all directions. Hypometric saccades in the horizontal and vertical plane with increased latencies (average = 228) were seen during saccade testing. Additionally, horizontal and vertical drifts during gaze stabilization testing were visualized. An inability to suppress the vestibulo-ocular reflex during attempted gaze fixation whilst doing full body rotations was also revealed.
Methods:
Thirty treatments, consisting of three 15-minute sessions, were administered over a 4-month period which consisted of head-eye vestibular motion therapy (including full body, head only and body only rotations both passively and actively whilst fixating on a target), eye movement therapy including gaze stabilization (lying, sitting and standing), pursuits, saccades and memory saccades. Other treatments included reactive targeting, mild electrical repetitive peripheral sensory stimulation (RPSS) to the trigeminal nerve (V1,V2 divisions) facially, interactive metronome exercises which consisted of clapping to a beat and rhythmic cross-crawl stepping, specific writing therapy including laser motion guidance and various other exercises on the neural sensory integrator as well as spinal manipulation.
Results:
One week after the first treatment the patient's caregiver reported significant improvement in the patient’s reading and writing. The patient achieved improved scores on his spelling tests and his handwriting was appropriately written on the line. One month post initiation of treatment, the patient achieved a perfect score on his reading exam. Three months post initiation of treatment the patient was able to read aloud and the patient’s writing was clearly legible and appropriate for his current age and development. Objectively, the patient’s eye movements and neurologic findings were improved, notably, there were significantly fewer saccadic intrusions during pursuits and gaze holding in the horizontal plane.
Conclusion:
This patient presented with visual disturbances and an inability to effectively read or write. After a short period of specific functional neurologic rehabilitation, the patient’s literacy complaints were resolved. As a consequence of the significant and substantive outcome of this case, further research is warranted to explore the efficacy of clinical neurological treatment in cases of visual and literacy dysfunction.
Keywords:
illiteracy,
Oculomotor Muscles,
chiropractic neurology,
adjustment,
Neurorehabilitation
Conference:
International Symposium on Clinical Neuroscience 2018, Orlando, Florida, United States, 24 May - 26 May, 2018.
Presentation Type:
Poster
Topic:
Clinical Applications in health, disease, and injury to the nervous system
Citation:
Ellis
M,
Le Lievre
T,
Lofgren
J and
Esposito
SE
(2018). Specific clinical neurological treatment for illiteracy and oculomotor dysfunction.
Front. Neurol.
Conference Abstract:
International Symposium on Clinical Neuroscience 2018.
doi: 10.3389/conf.fneur.2018.60.00131
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Received:
05 Apr 2018;
Published Online:
14 Dec 2018.
*
Correspondence:
Dr. Susan E Esposito, Life University, Marietta, United States, susanesposito@gmail.com