• Salminen BJ
• Izumi M
• Chung J

• Cervical Atlas
• Child
• Decompression, Surgical
• Grostic Technique
• Hemifacial Spasm
• Male
• NUCCA Technique
• Orthospinology Procedure
• Pediatrics
• Subluxation, Cervical

Objective: To describe the upper cervical chiropractic care of a pediatric patient with Joubert syndrome and hemifacial spasms.

Clinical Features: A 3-year-old boy with Joubert Syndrome presented to the office with tachypnea, occasional apnea, hemifacial spasm, nystagmus, strabismus, delayed motor skill development and hypotonia. The mother’s main concern was a hemifacial spasm that occurred three to four times a week. This was the patient’s first chiropractic experience. The atlas subluxation was detected from leg length evaluation, postural analysis and radiographic measurement.

Intervention and Outcomes: The patient received orthogonal-based, upper cervical low-force (UCLF) chiropractic care based on the National Upper Cervical Chiropractic Association (NUCCA) technique protocol. After the first adjustment, the patient did not have a hemifacial spasm for nine days, which was the longest interval between spasms since birth. The spasms completely disappeared after 31 months of care. Except for slightly improved coordination, no other significant change was reported as a result of the chiropractic care.

Conclusions: The positive response observed in this case suggests that hemifacial spasm may be linked to atlas subluxation. The need for further investigation of the connection between atlas vertebra subluxation and cranial nerve dysfunction is indicated.

Author Keywords: Upper cervical, subluxation, pediatric, Joubert syndrome, hemifacial spasm, Grostic, orthogonal, NUCCA, orthospinology, microvascular decompression

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