Locked-In Syndrome Following Cervical Manipulation by a Chiropractor: A Case Report

Abstract

Introduction Vertebrobasilar occlusion poses difficult diagnostic issues and even when properly diagnosed has a poor prognosis. Newer studies highlight a better outcome when thrombectomy was carried out between six and twenty-four hours after an initial diagnosis of stroke. This paper reports a case where a patient suffered a vertebrobasilar stroke secondary to a traumatic bilateral vertebral arteries dissection was treated with late thrombectomy. Case presentation A 34-year-old woman was manipulated on the cervical spinal column by a chiropractor. Following three weeks of cervical pain, she presented with severe aphasia and quadriplegia (NIHSS = 28). An MRI scan indicated ischemia of the vertebrobasilar system. Thirty-one hours after the onset of these symptoms, a thrombectomy was performed. After one month, the patient could move her head and the proximal part of her limbs but remained confined to bed (NIHSS = 13). Conclusion The current case illustrates the benefit of late mechanical thrombectomy for a posterior cerebral circulation infarct. Although there was a delay in treatment, partial recovery ensued.

Neglected cervical spondyloptosis of the 5TH – 6TH cervical spine following cervical manipulation: A case report

“…Reported mild complications including transient pain, increased musculoskeletal pain or discomfort, stiffness, headache, dizziness, tingling, or numbness in the upper limb. Other complications include spinal cord injury, nerve root lesion, disc herniation, ruptured discs, cervical fracture, epidural hematoma [13] , diaphragmatic paralysis resulting from C3–5 injury, quadriplegia, spondylolisthesis, and even death [3] , [4] , [14] .…”

Cervical Spine Manipulations: Role of Diagnostic Procedures, Effectiveness, and Safety from a Rehabilitation and Forensic Medicine Perspective: A Systematic Review

“…As highlighted in several analysed articles [2,4,9,10,14,[18][19][20][21][22], CSMs could lead to major irreversible, severely disabling, or even lethal adverse events. Hence, a proper assessment prior to the intervention is essential.…”

“…Orsini et al [20] described the clinical case of a 34-year-old woman who unde a CSM performed by a chiropractor. The procedure was followed by a traumatic bil VAD which resulted in vertebrobasilar stroke, presenting with tetraplegia and s Orsini et al [20] described the clinical case of a 34-year-old woman who underwent a CSM performed by a chiropractor. The procedure was followed by a traumatic bilateral VAD which resulted in vertebrobasilar stroke, presenting with tetraplegia and severe aphasia.…”

Locked In Syndrome, a Rare Clinical Presentation: A Case Report

“…9 Locked in syndrome has also been reported after SARS-coV-2 infection and cervical manipulation by a chiropractor. 4,10 Locked in syndrome carries significant morbidity and mortality. They need intensive care, full range of supportive therapy with extensive physiotherapy and rehabilitation for functional improvement.…”