Migraine, Vertigo, Nausea and the Vagus and Trigeminal Nerves
(Case Study — Long but Thorough)
Typical symptomatic presentation when Obliquus Capitis Superior is holding stability at the A-O joint because the OC Inferior on that same side and/or the opposite side cannot engage in rotation are: Migraine, Vertigo, Nausea, Weight loss (not secreting digestive juices to absorb nutrition from one’s food).**
A client came in recently with exactly these symptoms. In her case there is additionally Epilepsy added to the aftereffects of the TBI she first suffered 25 years ago. There were 2 TBI’s = a couple of years apart. Since then life has been a constant struggle just to cope. Migraines are frequent but the most disturbing element is Vertigo and Nausea.
Although she has sought help from MANY health professional ANYONE who could possibly help, more frequently these interventions have worsened the situation for as much as two weeks afterward. She’s very afraid to have anyone manipulate her neck.
When a client comes in who has experienced repeated shocks to the spine or head I ALWAYS test for basic contralateral coherence. A serious impact to the spine/brain results in a lingering trauma effect.
The neuromuscular result is general facilitation in the extensors along the spine and inhibition of flexion functions in the front of the body. An interesting psycho-emotional expression of this can be the subsequent inability to move forward in life and a great deal of confusion and cognitive delay.
The Trauma Effect ALWAYS INHIBITS the ability to easily cross the midline in movement, such as the request to turn one’s knees side to side while lying supine on a treatment table with knees bent. The ability to track the eyes left and right is usually disrupted as well, as is neck rotation.
In this case I skipped over testing neck rotations due to the Vertigo, but even LOOKING left with her eyes triggered a significant Vertigo response requiring us to pause while it settled. My usual approach of working with Brain Buttons to correct underlying contralateral confusion was arrested by my client’s inability to tolerate side to side movement.
I decided the priority in this case was to directly and immediately address the upper cervical rotations. But NOT before correcting something less challenging that would set the stage for her ability to be corrected in the upper cervicals.
I began with testing left SPS/right SPS/left SPS. Left SPS was dominant/facilitated; Right SPS was inhibited. After correcting this coordination confusion, in my post correction challenge, I also added the upper thoracic ability to rotate to the left. I wanted her body to experience success in stabilization at the neck base before challenging the smaller muscles at the top of the spine.
I found it necessary to move exceedingly slowly and test with only 2 ounces of pressure. My client was exceedingly nervous about ANYONE EVER working with her neck, but as I told her each step and checked in after each request to ‘match my pressure’ we were able to proceed. We also rebalanced the eye tracking function to the upper cervical rotations.
Additionally, I did a simple flexion/extension correction for the left hip as Iliacus was preventing the back and hip extensors from engaging to support her back and the dysfunction was producing a frequent pain in that SIJ area.
The result of this intervention was the ability to rotate the neck ‘better than at any point in the last 25 years’. “Why has NOBODY EVER figured this out?” was her next question. This is a clear indication that the work of NMR is needed in our PT realm, as this very subtle correction of sub-occipital rotators allowed a decompression of the Vagus nerve governing everything from Nausea, to Vertigo, to Diaphragmatic breathing and Heart rate regulation.
**(I’ve also seen this affecting TMJ and Trigeminal Neuralgia and Bell’s Palsy
