Children with Tremors and Conversion Disorder
A Possible Chiropractic Solution
Reporting a Limited Case Study
A report on the scientific literature
by Mark Studin DC, FASBE(C), DAAPM, DAAMLP
Chiropractors and chiropractic has been treating children safely for over 110 years for a host of maladies. In December, 2008, the National Center for Complementary and Alternative Medicine (NCCAM), part of the National Institutes of Health, released findings on Americans and the use of complementary and alternative medicine (CAM). "The findings are from the 2007 National Health Interview Survey (NHIS), an annual in-person survey of Americans regarding their health- and illness-related experiences. The CAM section gathered information on 23,393 adults aged 18 years or older and 9,417 children aged 17 years and under" (National Center for Complementary and Alternative Medicine, 2008, http://nccam.nih.gov/news/camstats/ 2007/camsurvey_fs1.htm). They found that 11.8% of children in the United States have undergone CAM therapies, indicating that children aren’t obtaining the desired outcomes and their parents are looking for solutions.
CAM is a term applied to any healing discipline that does not fall into the category of traditional medicine or any health care that traditional medicine must govern over, such as nursing or physical therapy, rendering those as secondary health care providers and not allowing them to care for patients unless under the supervision of a medical doctor. Chiropractic is considered part of CAM simply because doctors of chiropractic are not medical doctors or secondary providers requiring supervision by a medical doctor.
Miller reported in 2010 on 2,645 children that were treated in the outpatient clinic of the Anglo-European College of Chiropractic from 2006-2010 for various maladies. Of these children, 87% were under the age of 5 and 13% were between 5 and 13. 34% were seen for musculoskeletal problems such as neck pain and postural issues, 30% were treated for infant colic/excessive crying, 16% for feeding disorders and the balance for various other issues. Every child had been seen by at least one medical practitioner and some by many medical providers. Of the 2,645 children referred to the chiropractic clinic, 83% were referred by their medical physicians.
Marchand (2012) reported that an extensive European study was performed revealing that 8.1% of chiropractic practices were children between the ages of 0-18 (this is lower than the 17.1% of pediatric case loads of American Chiropractors.) This was based upon 921 doctors of chiropractic participating and reporting 19,821 pediatric visits, thereby certifying a valid cross-section of patients to conclude results.
The pediatric related conditions that were reported to be cared for by chiropractors were the following:
Miller and Benfield (2008) conducted a study of children younger than 3 years old to determine the adverse effects of chiropractic care in that age group, arguably the most susceptible to injury based upon the fragility of that age group. The study was based upon 5,242 chiropractic adjustments and if the results were extrapolated to the wider infant/toddler population that receives chiropractic treatment, the adverse reaction rate is expected to be 1 out of every 1300 chiropractic adjustments. There was less than 1% of patients experiencing negative side effects and all of these adverse reactions to care were mild in nature; transient and required no medical care with serious complications. The typical reaction was transient crying.
The “Practical Application” reported by Miller and Benfield was that chiropractic adjustments were safe for young children and adolescents.
Conversion Disorder according to Heruti, Levy, Adunski and Ohry (2002) has been previously labeled Hysterical Neurosis, Somatisized Disorder, Anxiety Hysteria and Hysterical Personality. Today's proper accepted nomenclature has been the simple use of Hysterical Neurosis, where Conversion Disorder is lumped together with Dissociative Disorder. This disorder, according to the authors is "disability to a psychological mechanism in people with physical impairment secondary to trauma without evidence of organic etiology (deviation or disruption from any internal organ, part or system)" Page 327.
Alcantara and Adamek (2012) reported "that an 11 year old girl with presented with complaints of uncontrollable tremors of both arms and right leg. Conversion Disorder was diagnosed following negative examination findings of an organic etiology. Prior to institutionalization, her parents requested a second opinion from a clinical psychologist who referred her to a chiropractor. Care was provided using spinal manipulation to sites of spinal and cranial dysfunctions. With subsequent visits the patient's tremors improved. Following 12 chiropractic visits the patient's symptoms resolved. Long-term follow-up revealed continued resolution of the symptoms of tremors." (page 89)
Although this is one case as reported in a limited case study, it adds to the growing body of the results chiropractic care. It also adds to the growing list of conditions chiropractors care for. Over time, research will continue to render more outcome statistics on the efficacy of chiropractic care. However based upon the current statistical conclusions, chiropractic is being utilized to help an array of maladies worldwide in both the pediatric and adult population with minimal to no side effects.
National Center for Complementary and Alternative Medicine. (2008, December). The use of complementary and alternative medicine in the United States. Retrieved from http://nccam.nih.gov/news/camstats/2007/camsurvey_fs1.htm\
2.Miller, J. (2010). Demographic survey of pediatric patients presenting to a chiropractic teaching clinic, Chiropractic & Osteopathy,18(33), Retrieved from http://www.chiroandosteo.com/content/pdf/1746-1340-18-33.pdf
3.Marchand, Aurelie (2012) Chiropractic Care of Children From Birth to Adolescence and Classification of reported Conditions: An Internet Cross-Sectional Survey of 956 European Chiropractors, Journal of Manipulative and Physiological Therapeutics, 35 (5) 372-380
4. Miller, J. E., & Benfield, K. (2008). Adverse effects of spinal manipulative therapy in children younger than 3 years: A retrospective study in a chiropractic teaching clinic. Journal of Manipulative and Physiological Therapeutics, 31(6), 419-423.
5.Heruti R., Levy, A., Adunski A. and Ohry A., (2002) Conversion Motor Paralysis: Overview and Rehabilitation Model, Spinal Cord, 40, 327-334
6. Alcantra J., Adamek R., (2012) The chiropractic care of a child with extremity tremors concomitant with a medical diagnosis of conversion disorder, Complementary Therapies in Clinical Practice, 18, 89-93