Isaacs syndrome is a rare neuromuscular disorder characterized by chronic muscle stiffness, cramping, fasciculations, myokymia, and hyperhidrosis. Pathogenesis includes autoimmunity, paraneoplastic disorders, genetic predisposition, or toxin exposure. There is no known cure for Isaacs syndrome. This case report describes a patient who had been given the diagnosis of Isaacs syndrome and received osteopathic manipulative treatment to manage fascial and cranial dysfunctions and reduce nervous system hyperexcitability. Long-term decrease of myokymia and reduction of severity and frequency of exacerbations resulted.

Osteopathic manipulative treatment (OMT) has been used in the treatment of pediatric patients for decades. The authors performed a systematic review to find evidence showing the safety and efficacy of OMT use in pediatric patients for common pediatric conditions seen in the outpatient setting. The conditions reviewed are otitis media and asthma, as they are the most common acute reason children under age five present to their physician and the most common chronic condition affecting children, respectively. The review found evidence of OMT being beneficial in the reduction of middle ear effusions following otitis media. The use of OMT was also shown to increase the peak expiratory flow of children with asthma. Very few studies have been performed to show the safety of osteopathic manipulative treatment; however one study showed that the incidence of iatrogenesis is minimal. Several easy-to-use techniques are demonstrated in the hopes that this will encourage more osteopathic physicians to incorporate the use of OMT into daily practice. As it stands, more studies are needed to give statistical significance and to prove that OMT is a safe, effective, non-invasive option for the treatment of various pediatric conditions.