news for all who want to learn
New Stroke Recognition Tests
One of the major concerns for chiropractors are stroke patients. Current research associates the risk of stroke after a cervical manipulation as about 1 in a million. However, these stats may be artificially high, since often people who seek chiropractic care for neck & head pain often have these symptoms because they are currently in a stroke status.
That makes it critical, both for patient safety, and our professions reputation to establish methods to detect a stroke patient before any manipulation is provided. In the past, orthopedic tests have been notoriously inaccurate (Drift Test, George’s, etc..) and thus many doctors do not even use them. To date, our best indicator was the patient’s presenting history.
But in addition to a proper history, a new serious of neurological bedside tests finally provide some solid clinical data. Dr. David Newman-Toker recently presented a short series of examinations that proved to be 100% sensitive and 96% specific. Of course further testing needs to be done, as this was a single center study of high risk patients, but regardless it is quite promising.
Newman’s tests included:
- Strong Horizontal head impulse (a normal patient & a stroke patient’s eyes stays stable during the impulse, an inner ear complication would result in an ‘eye flick’).
- Nystagmus (Lateral in the same direction as the patient is looking, occurs when the patient looks in either direction)
- Downward alignment of the eyes when one is rapidly covered and uncovered.
As I research continues on this subject I will update this article.
View the demonstration here… http://www.medscape.com/viewarticle/710698 (you may be required to sign up to view it).
If chiropractors can't rule out a stroke they shouldn't adjust. This is just proof that Chiropractors are reckless and that people should see MD's only.
I agree with twilson, I don't see any md's adjusting people's necks! You're quack actoins are just dangerous.
Hardly the purpose of this article, but at any rate I'll reply. Your comments are fortunately, inaccurate. MD's prescribe medications that have far higher risk rates than those seen in Chiropractic, for example statins which are given to prevent heart attacks are actually linked to causing heart attacks. That does not mean MD's are Quacks and dangerous, they are just using the best tools that they currently have, as do chiropractors.
If you doubt my statin statement I'll write an article on that topic in the near future.
In response to twilson, it would be quite difficult to “rule out” something that hasn't actually happened yet when the patient is in the chiropractor's (or MD's) office. As for the blanket statement that chiropractors are reckless, my first visit to the chiropractor for unrelenting headaches was a far superior diagnostic experience than the visit to an MD for the same complaint. The MD spent less than 15 minutes with me and wrote a prescription to be taken each time I had a headache, which was every day. He had never even met me before that day! In contrast, the chiropractor performed a thorough orthopedic and neurological exam and took x-rays that were read by an outside radiologist before laying one hand on me. On the day I received my first adjustment I walked into the office with the same headache I had every day for the last several weeks…and walked out without it! The headaches have not returned to this day and I will forever be grateful to the chiropractor who lifted that burden.