Nonpharmacologic Management of Recurrent Painful Ophthalmoplegic Neuropathy: A Case Report

TL;DR

A woman with a rare nerve disorder found relief through chiropractic care and acupuncture after medications failed.

Contribution

This case report suggests nonpharmacologic therapies may be effective for managing recurrent painful ophthalmoplegic neuropathy.

Findings

Spinal manipulation and acupuncture resolved symptoms in a patient with RPON unresponsive to medications.

Nonpharmacologic treatment led to complete symptom resolution over six weeks.

The case highlights a potential alternative treatment approach for RPON.

Abstract

Recurrent painful ophthalmoplegic neuropathy (RPON) is a rare neurologic disorder characterized by headaches and ocular cranial nerve paresis with no consensus on optimal treatment. While pharmacologic treatments are commonly used, limited research has explored nonpharmacologic options. A 36-year-old woman with a multi-year history of episodes of RPON lasting several months presented to a chiropractor with a week-long episode of headache and diplopia unresponsive to oral steroids and sumatriptan. Spinal manipulation and acupuncture were administered over six weeks, leading to complete symptom resolution. This is a case of RPON managed successfully with chiropractic care and acupuncture, suggesting a potential beneficial role of these therapies. Given the limitations of a single case, further research is warranted to determine the effectiveness of these therapies for RPON.

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