Improvement in achalasia following a neurological rehabilitation program: a case study

Abstract

Event Abstract Back to Event Improvement in achalasia following a neurological rehabilitation program: a case study George Michalopoulos1, Fili Talamantez1 and Derek Barton2* 1 Illinois Neuro and Physical Rehabilitation, United States 2 Carrick Institute, United States Background A 32-year-old female patient presented to a functional neurology practice with complaint of achalasia that came on 10 years prior. The patient had previously used surgical intervention to manage the condition with some success, however, her condition began to worsen over the past several months before her visit. The patient presented with complaints of difficulty swallowing and digesting food. Barium swallow studies showed persistence of contrast agent in the esophagus after five minutes. Methods Neurological examination revealed left beating nystagmus. Pursuits had saccadic intrusions with eye movements up and to the right and down and to the left. The patient had decreased amplitude of optokinetics to the left. The patient had absence of her gag reflex and finger to nose was dysmetric on the right. The patient was diagnosed with achalasia. A treatment plan consisting of intense parasympathetic stimulation and brain-based therapy was implemented. The patient performed manual stimulation of the gag response, gaze stability exercises, complex movements of the extremities, and vibration exercises on the left side. Results The patient reported improvement in her ability to swallow and digest food. A follow-up barium swallow study showed the patient was able to clear the contrast in under one minute. Conclusions A patient scheduled for esophageal surgery finds relief through conservative neurological rehabilitation. Further research is suggested to investigate this approach in a larger population of achalasia patients. Acknowledgements Joseph Lawrence, Ralph DeStephano, Anthony Lemmo Keywords: Achalasia, Parasympathetic Nervous System, Neurorehabilitation, conservative treatment, Esophagus Conference: International Symposium on Clinical Neuroscience: TBI and Neurodegeneration, Orlando, Florida, United States, 10 Dec - 14 Dec, 2015. Presentation Type: Poster Presentation Topic: Case Reports for Poster Presentation Citation: Michalopoulos G, Talamantez F and Barton D (2015). Improvement in achalasia following a neurological rehabilitation program: a case study. Front. Neurol. Conference Abstract: International Symposium on Clinical Neuroscience: TBI and Neurodegeneration. doi: 10.3389/conf.fneur.2015.58.00016 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 01 Nov 2015; Published Online: 02 Nov 2015. * Correspondence: Dr. Derek Barton, Carrick Institute, Cape Canaveral, FL, United States, derekabarton@gmail.com Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers George Michalopoulos Fili Talamantez Derek Barton Google George Michalopoulos Fili Talamantez Derek Barton Google Scholar George Michalopoulos Fili Talamantez Derek Barton PubMed George Michalopoulos Fili Talamantez Derek Barton Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.