# 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.

## Key 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.