A Patient’s Perspective – March 2004 (Parkinson’s disease)
I continue to be amazed at what I read in the research. The cervical spine, in particular the upper cervical spine is mentioned in most of the research (chiropractic and medical) I have located. It is such a vital area which is the main communication pathway between your body and brain and yet apart from obvious injuries like fractures or other pathologies it is rarely analyzed in detail. Why do some medical researchers not see the importance of this area in the conditions they are investigating? Why are charitable foundations which are set up to support research into a particular medical condition or disease not interested including upper cervical chiropractic in the investigation and funding process? Why is research into pharmaceutical outcomes favored over alternative and complementary approaches? I would have thought that patients’ interests are what are most important and therefore any and all possible solutions to disease eradication should be researched? Scientific researchers should be given freedom to investigate any and all options rather than having them focus on pharmaceutical or surgical solutions.
In this issue I have provided some research information on the condition Parkinson’s disease. I chose this one because I have a friend who is struggling with the disease at the moment. There is some interesting research and case studies which would seem to point once again to the cervical spine as being a culprit. I did once convince my friend to visit an upper cervical chiropractor. He had an amazing response to the treatment as you can see by his communication to me soon after his first atlas adjustment.
WE SAW [the chiropractor] TODAY. HE TOOK 3 X RAYS AND ZAPPED US TWICE!.
ALREADY BOTH OF US CAN MOVE OUR HEADS TWICE AS FAR!! MY NECK WAS ABOUT 8 DEGREES OFF CENTRE.
WE ARE THRILLED AND GO BACK TOMORROW FOR MORE X RAYS AND ZAPS.
THANKS FOR YOUR SUGGESTION AND CARE I OWE YOU A FEW BEERS!!! LOOK FORWARD TO SEEING YOU ALL SOON”
To look at my friend you could see his head was very noticeably tilted to one side and his head was quite forward. His trapezius muscles are extremely tight, the sternocleidomastoid is under tension on one side, and the scalenes seem very tight and bulky (scar tissue?). Apart from the Parkinson’s symptoms he also has tinnitus, deafness, tingling & pins and needles and pain in the neck and shoulders. In other words he appears to have a massive atlas subluxation which, as you can see from the above communication was evident on x-rays. He would need ongoing treatment for a lengthy period.
Sadly he did not continue with this treatment (AO upper cervical chiropractic) as he was basically told by his doctors that neck problems could not be a cause of Parkinson’s disease. I could not persuade him or his wife to keep up the treatment and was told in no uncertain terms that Parkinson’s disease was a problem with the brain and there is no way the neck could be involved. I beg to differ and in this edition of my newsletter I will explain my opinions and conclusions. My friend is lost to the medical profession having now graduated firstly to a motorized scooter and more recently to a nursing home periodically! This is a tragedy and I feel for my dear friends; however I am no match for the medical system and the misleading information spread about chiropractors.
I hope you enjoy my newsletters and as always feel free to provide me with any feedback and suggestions to firstname.lastname@example.org. Remember I am a patient and not a medical practitioner; however I am entitled to my own opinion. People are free to disagree with me. My newsletters are provided as an informational source only, and are not a medical opinion. Therefore you should do further research for yourself and make your own decisions.
What is Parkinson’s disease (PD) according to medical science? PD is a progressive neurological condition affecting movements such as walking, talking and writing. PD has three main symptoms which are tremor, muscle and limb rigidity & stiffness and slowness of movement. Other symptoms include loss of balance, constipation, tingling & prickling sensations in the limbs, tiredness and depression. However, the tiredness and depression I contend are as a result of contracting the disease and not a symptom of the disease. According to American Parkinson Disease Association Inc. “Parkinson’s disease is caused by the degeneration of the pigmented neurons in the Substantia Nigra of the brain, resulting in decreased dopamine availability.” It is this decreased dopamine phenomena which is the focus of much of the current research and the target for therapeutic drug intervention. There would, however, appear to be other treatment alternatives which need to be investigated.
One particular doctor Fernandez Noda has done some work which really interests me and I contend his work confirms that injury to the cervical spine as I describe on my website is a major contributor to the development of PD if not the main causal factor in the disease. If this is the conclusion then maybe upper cervical chiropractic can help people with Parkinson’s disease? The first paper I would like to refer to by Fernandez Noda and Lopez in 1984 describes a surgical technique for a condition referred to as thoracic outlet syndrome (TOS) in later papers cerebellar thoracic outlet syndrome (CTOS) and more recently cerebral thoracic neurovascular syndrome (CTNVS). The doctors carried out surgery on 71 patients presenting with TOS which “the signs and symptoms are considered to be caused by neurovascular compression through boney, muscular or ligamental structures in the thoracic outlet.”Reported symptoms include paresthesia (tingling, prickling, burning-abnormal sensations), pain, weakness, dizziness, transient blindness, fainting and coldness in fingers/hands/face. The paper discusses complete (100%) removal of the signs and symptoms following division/section of the anterior scalene muscle compressing neurological and vascular structures in the region (thoracic outlet just above the clavicle), with no recurrence of symptoms.
In another paper Fernandez Noda et al conclude that “Parkinson’s disease is a complication of CTOS, caused by insufficient irrigation of the dopamine producing cells and subsequent reduction of dopamine secretion.” Using a surgical technique to perform a division of the scalene muscles (scalenotomy) in order to remove neurovascular compression the authors achieved excellent results with 5% of patients reported completely cured of Parkinson’s symptoms and a further 80% showing significant improvement and able to reduce their dependence on medication. The authors state “After operation, these patients continue to take anti-Parkinson drugs etc. in progressively decreasing quantities until symptoms abate and further medication is unnecessary.” Further they conclude “compression is produced by the anterior scalene muscles and the cervical ribs at the level of C6-7. The faulty irrigation of the cerebellum and cerebral cells produces CTOS and its complications, notable among which are ipsilateral paralysis and Parkinson’s disease.”
A single case report by Sell et al discusses a “tight anterior scalene muscle”resulting in “entrapment of the left vertebral artery”about 2cm from its origin when the patient turned her head to the left. If the patient turned her head “excessively to the left” she would present with, amongst other brain stem symptoms, “global binocular blindness” and her vision would “quickly return to normal when she turned her head to the right”. The surgeons discovered that the scalene muscles (anterior and middle) were also compressing the lower cord of the brachial plexus. These muscular compressions of neurovascular structures are important in forming the conclusion that upper cervical chiropractic can and does assist in relief on CTOS symptoms and more than likely Parkinson’s disease symptoms.
Fernandez Noda et al paper describes “the role of compression of the vertebral, subclavian arteries, internal mammary, internal carotid arteries, brachial plexus and coiling and kinking of the vertebral and basilar arteries, the faulty irrigation of blood supply and oxygen of the cerebellum and basal ganglia of the brain.” Basically their conclusion is that this compression which is caused by the “anterior scalene muscles and the cervical ribs at the level of the C6-7 vertebrae; by the sternocleidomastoid at the level of the cervical atlas; coiling and kinking of the vertebral, basilar and the internal carotid arteries” produces the symptoms of Parkinson’s because the effect of the compression of these vital structures is to “decrease secretion of dopamine at the level of the basial ganglia (putamen, caudate, thalamus)”. The authors discuss PET scanning which reveals that the illnesses “epilepsy, memory deficit, agnosia, dementia, Huntington’s disease, chronic schizophrenia and manic depression … demonstrate intermittent and patchy decreases in blood flow”. They report significant improvements in people with all these diseases and 88% healing results for Alzheimer’s disease. They also report having operated on 17 patients with multiple sclerosis and 12 having “shown great improvement” and their “colleagues in Spain have had excellent results with 40 multiple sclerosis operated patients.” They conclude with a view that the neurovascular compression mentioned earlier which, in their opinion results in reduced oxygenated blood to the dopamine producing cells, can be relieved by their surgical technique (scalenotomy) and the results are positive in “CTOS, symptomatic Parkinson’s disease, Alzheimer’s disease, psychological disturbances by hypoxia, epilepsy, multiple sclerosis, hemodynamic parkinsonism and impending gangrene of the upper extremities.”
Fernandez Noda et al in this 2002 paper have renamed the syndrome to cerebral thoracic neurovascular syndrome (CTNVS) when they discovered that the internal carotid arteries were part of the syndrome (pg. 58) and in their abstract reiterate conclusions from the previous papers, “decreased blood supply to the cerebellum and basal ganglia is the cause of the CTNVS and its neurological complications, among which are ipsilateral paralysis, symptomatic Parkinson’s disease, functional Alzheimer’s disease, multiple sclerosis and others.” They further reinforce that the symptoms associated with these diseases are caused by compression of vital neurological (e.g. nerves and nerve plexuses) and vascular structures (arteries and veins) both at the C6-7 level and at the level of the cervical atlas (C1), by muscles such as the anterior and middle scalenes, the sternocleidomastoid and other neck muscles. The compression causes “sporadical insufficient blood supply and oxygen to the cerebellum, brain and the twelve cranial pair nerves”. They list great improvements in many patients with these diseases when they carry out their surgical procedure to remove the compression on the neurovascular structures. As mentioned before this surgery involves removing muscle which causes the compression. They state “all symptoms disappeared after surgery” in many cases involving the different diseases. They list the symptoms of CTNVS on page 56 of the paper under the heading “Symptomatology produced by CTNVS”. This list includes all of the symptoms which have been demonstrated to be relieved with treatment by upper cervical chiropractors. If you also refer to my symptoms at http://www.upcspine.com/greg4.htm you will note how closely my symptoms at the time correlated with CTNVS. I wonder what Fernandez Noda and his colleagues would say to those doctors who told my friends that Parkinson’s disease was not related to the neck.
On my website you will also find that I frequently refer to compression of vital neurological and vascular structures by the muscles which have the job of holding the head atop the cervical spine. These structures include the jugular vein, vertebral and carotid arteries, phrenic nerve, brachial plexus, and the cranial nerves, vagus, glossopharyngeal, spinal accessory and hypoglossal. It makes complete sense that if one’s head has been shifted on the atlas due to trauma then muscle imbalance, spasm and compression or traction of vital structures will result. You will note I also discuss the need to address the dental mal-occlusion which can be a result of upper cervical subluxation. At this point I refer you to a very interesting paper well worth reading by Dr A.C. Fonder, “The Dental Distress Syndrome Quantified” http://www.icnr.com/DentalDistressSyndrome/DentalDistressSyndrome.htm. Fonder discusses the relationship between dental occlusion and posture and human ailments. Note references to successful treatment of Parkinson’s.
I think that Fernandez Noda et al have done a wonderful job of explaining exactly what the causal mechanisms of human disease are and I continue to wonder why their work is not more widely heralded by medical organizations. If you look closely at people with Parkinson’s or any other disease you will notice the signs of muscle imbalance, poor posture, muscles struggling and fighting to maintain balance.
- Could CTNVS be nothing more than a subluxation in the upper cervicals?
- My conclusion is most definitely yes!
- Can people with CTNVS, Parkinson’s or other disease be helped with upper cervical chiropractic?
- In my opinion – Yes!
- Should conservative treatment (a.k.a. upper cervical treatment) be tried before invasive procedures?
- Of course – Yes!
A video-tape of a dissection of the cervical spine is also interesting because it demonstrates the anatomy of the cervical spine and the scalene muscles very well. About 36.5 minutes into the videotape, thoracic outlet syndrome (TOS) and tests are demonstrated and explained. The authors note the number of people they see in their clinic with forward head posture and suggest compression of the brachial plexus and other neurovascular structures (e.g. carotid sheath which contains the jugular vein, carotid artery and sympathetic chain) in and around the scalenes can occur. According to the authors “the close proximity of soft tissues and bony structures create the potential for compressive and tensile forces on the neurovascular structures in this area.” It is emphasized that proper position of the head and neck a vital to a healthy cervical spine. If you get to watch the tape, think about an off centre head and what might happen to the cervical spine muscles as they try to hold the head erect. In my opinion TOS, CTOS and CTNVS are the result of an upper cervical subluxation and it follows that correction by specific upper cervical chiropractors can relieve myriad symptoms associated with these syndromes without the need for invasive surgery.
A paper by Herrera-Marschitz, Utsumi and Ungerstedt is very interesting and it has nothing to do with humans. Experiments were done on rats which when subjected to decreases in dopamine; scoliosis of the spine was a direct result. In fact, “rats with the strongest dopamine depletion (greater than 95%) and the strongest rotational responses showed the sharpest spinal deviation and skeletal deformity. These findings agree with the clinical observations that scoliosis occurs in patients with Parkinson’s disease and its direction is correlated with the side of the major signs and symptoms of parkinsonism.” This could further reinforce that Parkinson’s and other diseases are a result of an upper cervical subluxation as it is well known and well recorded that upper cervical subluxations result in scoliosis (see my February 2004 newsletter about fibromyalgia).
Chiropractic and Parkinson’s disease
A search for Parkinson’s research and chiropractic does not turn up voluminous studies. I believe this to be a function of research funding which usually is channelled toward pharmaceutical outcomes. It would be a brave doctor who recommended to a research organization or government body that funding is directed towards chiropractic research! There are however a couple of studies worthy of mention. The first is a case report by Elster an upper cervical chiropractor from Colorado, USA. This is the case report of a 60 year old man who was diagnosed with PD at age 53. Elster used “paraspinal digital infrared imaging” and “precision upper cervical radiographic series” of x-rays and cites “6,000 peer-reviewed and indexed articles” as well as “blind studies comparing thermographic results to CT-scan, MRI, EMG, myelography and surgery, thermography was shown to have a high degree of sensitivity (99.2%), specificity (up to 98%), predictive value and reliability”.
The author discovered through her upper cervical methodology that the patient had “right laterality of the atlas.” In other words, the patient had an upper cervical subluxation of atlas. After receiving consent, “treatment began with an adjustment to correct the right laterality of atlas.” The adjustment was performed using the knee-chest adjustment technique which is described on my site at http://www.upcspine.com/tech12.htm and the usual protocols associated with that technique were followed.
Following further treatment by the end of the 2nd week of care the patient “reported greater range of motion in his neck, improved sleep, better energy, and decreased stiffness in his overall body.” Utilizing the United Parkinson’s Disease Rating Scale (UPDRS) a “re-evaluation revealed a reduction in symptoms” accompanied with an overall “43% improvement”. Other improvements not listed in the UPDRS understated the improvement as “it did not take into consideration other associated symptoms, such as spinal pain, insomnia and fatigue”. The patient continues under the care of Elster and maintains the improvement as well as exhibiting no deterioration in condition. He has also started a regular exercise and training program.
The patient reported a history of trauma “6 specific incidents” prior to the onset of symptoms including significant trauma to the head. Elster concludes with some theories as to the connection between the head injuries, the upper cervical subluxation and the onset of PD. One theory suggests that “sympathetic malfunction occurred, possibly causing a decrease in cerebral blood flow compromising a patient’s substantia nigra”. She rightly states that this one case does not confirm a link between an upper cervical subluxation and PD, however combined with the CTNVS studies and other known facts about the consequences of upper cervical subluxations it is not hard to make the connection. It only needs to be researched.
A second article by Elster a copy of which can be found at http://www.erinelster.com/Articles/parkinsons_article%20_07_00.html discusses 10 cases of PD and the “results revealed a substantial improvement in subjective and objective findings in 6 out of 10 patients and mild improvement in 2 patients. The final 2 patients remain unchanged.” All patients had atlas subluxations which were visible on precision upper cervical x-rays.
In another paper by Burcon finds remarkably consistent findings in a number of patient’s with a variety of conditions. All exhibit upper cervical subluxations and all improved following upper cervical chiropractic intervention. Burcon concludes with the theory amongst others “ pressure exerted by the subluxated atlas causes a combination of problems including, decreased blood supply to the occipital portion of the brain; pressure on the nuclei of cranial nerves V (trigeminal) and VIII (vestibulocochlear); nerve-root irritation of cranial nerve VIII.” These would seem to be in agreement with Fernandez Noda with respect to decreased blood flow and cranial nerve impairment. Reduced blood flow to cranial nerve VIII for example most likely would result in hearing disorders like tinnitus and deafness. Interestingly in some Doppler sonography studies, of people with tinnitus, blood flow is significantly reduced in the vertebral artery on the side of the tinnitus.
Someone Please Save the Pope!
There are a number of celebrities who have been diagnosed with PD most notably Mohammed Ali, Michael J. Fox and of course the Pope. In just about every photo that I have seen of Michael J Fox he favors having his head forward and to the right and side-on photos would “seem” to indicate loss of cervical curve. The photo on this page is an example http://mjftribute.tripod.com/mikephoto3.htm. Now I’m not saying that this is definitive, however a quick check by Michael himself may reveal that he does have right head tilt and has had it for some length of time. A tilted head is often a result of atlas subluxation. Has he had a head injury? Probably. Has Mohammed Ali had a head injury? Yes!
Upon observing the posture of Pope John Paul II on many occasions and looking at some photos at http://przewodnik.iq.pl/fatima/page_02.htm, I have to conclude that he exhibits the ‘classic’ upper cervical (atlas) subluxation, exaggerated thoracic kyphosis and lower spine compensatory subluxation. His head is so far forward that compression of neurovascular structures in his neck and of the brachial plexuses as suggested by Fernandez Noda et al is highly likely. The forward head carriage of the Pope is NOT a normal part of the aging process which some people would have us believe. It is due to cumulative trauma throughout one’s life, subluxating atlas, which never gets corrected. I would further suggest that because of the ‘link’ between upper cervical subluxations and hearing disorders, the Pope is more than likely exhibiting both tinnitus and deafness. Why don’t his doctors address the Pope’s obvious postural anomalies?
People who suffer head injury are four times more likely to develop Parkinson’s disease. The study also found that this risk increases eightfold for people with a head trauma requiring hospitalization and 11-fold for those with a severe head injury, characterized by long loss of consciousness and brain bruising. Lead author Dr James Bower, a Mayo Clinic neurologist, says: “I was surprised by the strength of the association and was also surprised that the average head trauma was about 20 years before the start of the disease.” Details of the study are published in Neurology.
Compiled by Kym Nicoll – Sydney Morning Herald (Sydney, Australia) Thursday 22 May 2003 Health & Science section P.1
As mentioned earlier Erin Elster www.erinelster.com is achieving wonderful results with a range of conditions. See her testimonial site http://www.erinelster.com/Case%20Studies/parkinsons_case_studies.html for some great Parkinson’s success stories.
A patient developed Parkinson’s like symptoms such as tremors with facial twitches one hour after taking a prescribed medication. When the patient was told to discontinue the prescription, the symptoms worsened. After being under upper cervical care for one month her symptoms have decreased by 50% and are progressively getting better.
A Parkinson’s patient with pill rolling hand tremors, slurred speech, vacant look, extreme head posture with the head in extreme chin to chest position. Two days after an atlas adjustment the patient waltzes into the office with her head in a normal position speaking normally and without tremors.
A Parkinson’s patient who fell off the rings in gymnastics as a youth and would have similar spasms, arm extension seizures,…Despite a 3 hour round trip needed to get UC care, the man claims to already be 60% better after only two weeks of care!!!
Parkinson’s case with persistent tremors in both her arms and legs. Within one week, the tremors have dramatically dropped and the strength is coming back into her arms!
I have a Parkinson patient, who has only received one adjustment. She was my first patient adjusted. Her neurologist is shocked by the changes, and she called and scheduled next week.
Had a fellow in his eighties with severe Parkinson like head tremors who was one of my first people last November. Adjusted him 11/30 and checked him weekly for 2 months and now monthly. He held his first correction till April and the tremors where gone by January!
A middle aged woman with Parkinson’s. She was continually rolling and jerking her head every three seconds and the right arm kept contracting towards her chest. After being scanned and precisely adjusted, right on the table the head tremors stopped and as she sat up, the arm contractures reduced by 2/3rds.
I have one lady that had Parkinson’s, daily seizures, and is confined to a wheelchair. The symptoms started after she received a TB medication for a sore throat. She hasn’t had a seizure in 3 weeks, her arms are less rigid, and she jumped out of bed one night and tried to make a run for it (falling after a few meters, but she was holding strong when I checked her the day after). She has started talking more, the first two weeks she said nothing. She has the mask face typical of some Parkinson’s patients, one day she came in on a cloudy morning and smiled for the first time in a while, and miraculously the sun came out from behind the clouds beaming in on her face. It was a very emotional moment for me because you realize who is really doing the healing. Her family has also reduced all the meds she was taking, (probably why she is healing so fast) I have been refining my technique every morning before I start seeing patients. I just went through the travel cards and I have 9 patients who have only ever had one correction over a period of many months.
A Parkinson’s patient is now able to walk without his walker and his BP is normalized. (He’s off the meds) His wife continues to comment that he is more trouble now than before his correction because he’s into everything! He is driving again, shooting his shotgun at matches and he says, “I feel like me again.
A Parkinson’s patient. The woman had persistent head tremors and left her arm would jerk upward involuntarily. The UC doctor’s assistant had to hold the patient’s arm and head, the husband held her lower torso while the doctor adjusted the atlas. When they sat her up, her rigid arm was relaxed as she was fanning herself due to the warmth she was feeling. (We’ve all had the patient who describes that hot water flowing down the back feeling…and you know you cleared them.) Anyway, the head tremors STOPPED post adjustment.
The two key features of a Parkinson’s Disease (PD) case I am currently looking after for, this particular blog post are:
- To differentiate resting tremor (a feature of PD) from essential tremor (not a feature of PD); and
- To illustrate an almost complete reversal of micrographia (small handwriting) through upper cervical specific chiropractic care.
The Chiropractic Green Books
Copyright with permission – Chiropractic Books www.chiropracticbooks.com
There are only a few references to PD by B.J. Palmer who reported the use of upper cervical chiropractic care for PD patients. In the Greenbooks, he referred to patients having “shaking palsy” also referred to by Firth as Paralysis Agitans (see below). Palmer listed improvement or correction of symptoms such as “tremor, shaking, muscle cramps, muscle contracture, joint stiffness, fatigue, incoordination, trouble walking, numbness, pain, inability to walk, and muscle weakness.” His upper cervical chiropractic care included use of the neurocalometer (NCM) thermal scanning device as discussed in last month’s newsletter. Note he recommends adjustment to atlas (C1) or axis (C2).
Definition.—This is also called Parkinson’s disease or shaking palsy, and is a chronic incoordination of the muscles, characterized by muscular weakness, tremor and flexor rigidity.
Adjustment.—Atlas or axis.
There is no known pathology and no definite nerve-tracing in shaking palsy. Most cases begin after the fortieth year of life.
Symptoms.—This usually begins with slight aching pains in the thumb and first two fingers of one hand, and a slight unsteadiness of the thumb of the affected hand, which soon develops into a tremor. Later the tremor starts in the fingers, and the characteristic “bread crumbling, or pill rolling” movement is noticed. The extent of the tremor increases so that the entire forearm trembles, and the tremor begins to be noticed on the hand of the opposite side. The legs, face, and neck muscles may become affected. There is a marked flexor rigidity affecting all of the muscles of the body so that the patient always assumes a stooped position, the knees are bent, the forearms are flexed upon the arms, and the trunk leans forward.
The festination or propulsive gait is characteristic of this disease; in it the patient leans far forward, and it appears that he is on the point of running or that his gait is increasing in speed and his steps are shuffling. It is difficult for him to stop quickly or to turn a corner, the voice becomes weak and high-pitched, the saliva is secreted in excess, and often dribbles from the mouth, and the patient is usually emotional. The movement temporarily stops upon voluntary movement and during sleep. The patient is usually restless, and sleeps poorly. The general health may be fairly good, and life is not greatly shortened by the paralysis, but the patient may become entirely helpless.”
In the Greenbooks Palmer discusses one PD case as follows:-
“We recall a case of paralysis agitans. We mentioned, one day, that we thot shaking of right hand was less. She denied it. We said nothing more, but watched right leg. Every day that case came, we watched right leg. After two weeks, satisfying ourself that right leg did not shake AT ALL, we asked her how her right leg was, and she affirmed that “it is the same, no better.” We told her. She was surprised and had to remember back that there was a time when it did shake ALL THE TIME and now it did not shake AT ALL. Then she admitted she was better.”
Palmer also provides a table/(list of conditions) in which he lists the number of cases by condition. This list shows “5 Cases of Shaking Palsy” – p869 and “2 cases of paralysis agitans” – p868. Palmer further demonstrates that in the majority of cases it was the upper cervical spine which was adjusted. In 94% of cases the adjustment was either to the atlas or the axis ONLY. Notably 97.4% of patients either got well or improved.
This report shows that out of 5,000 cases, 3,856 got WELL and 1,013 IMPROVED, by adjusting ONE place only in 4,904 cases and TWO or more places in 96 cases, with an average of 8.9 adjustments per case, with an average adjustment given 1 in 6.9 days; where ATLAS ONLY was adjusted in 1,829 cases; AXIS ONLY in 2,872 cases; 3rd CERVICAL ONLY in 157 cases; 96 other places in other cases; Spinograph being used in 2,564 cases and palpation in 1,912 cases. The report further proves that the NCM was 100% exclusively used, as the efficient, competent, accurate, and honest means used on 5,000 cases to locate the interference and determine the mace of and for adjustment.
The phenomena of atlas subluxations which manifest as poor posture would seem to be evident in PD as well as many other serious human diseases. I think these postural anomalies most definitely caused by upper cervical subluxations should be addressed before any other medical intervention. Let’s see what happens when these postural distortions are corrected. Research organizations serious about finding cures for a range of human diseases should work with the best minds in upper cervical chiropractic. The day that happens will truly be a wonderful day for us patients.
 Esteban I. Fernandez Noda, M.D. – Mimiya and Auxilio Mutuo Hospitals-San Juan, Puerto Rico.
 Fernandez Noda EI, Lopez S; Thoracic outlet syndrome: Diagnosis and management with a new surgical technique. Herz 9 (1984), 52-56 (Nr.1)
 Fernandez Noda EI, Lugo A, Berrios E, Rodriguez de Valle J, Alvardo F, Buch MS, Perez Fernandez J; A new concept of Parkinson’s disease as a complication of the Cerebellar Thoracic Outlet Syndrome. Japanese Annals of Thoracic Surgery 1987;7(3):271-5
 Sell JJ, Rael Jr, Orrison WW; Rotational vertebrobasilar insufficiency as a component of thoracic outlet syndrome resulting in transient blindness. J Neurosurg 81:617-619, 1994
 Fernandez Noda EI, Nuňez-Arguelles J, Perez Fernandez J, Castillo J, Perez Izquierdo M, Rivera Luna H; Neck and transitory vascular compression causing neurological complications-Results of surgical treatment on 1,300 patients. J cardiovasc surg 1996;37(Suppl. 1 to No. 6):155-66
 Fernandez Noda EI, Rivera Luna H, Perez Fernandez J, Castillo J, Perez Izquierdo M, Estrada C; New concept regarding chest pain due to hypoxia of the internal mammary arteries in more than 1,600 operated patients with cerebral thoracic neurovascular syndrome (CTNVS). Panminerva Med 2002;44:47-59
 Symptoms of CTNVS (pg 56)-headaches (migraine), neck and thorax pain, chest pain and arm numbness, shortness of breath, sleep apnea, diurnal apnea, memory deficit, absences, disorientation, dysphagia, dizziness, tinnitus, urinary incontinence, speech difficulty, loss of consciousness, ipsilateral palsy, severe stress, temporomaxillar joint pain, amaurosis fugax, tachycardia, dysmenorrhea, profuse menstrual bleeding, severe constipation, paresia, snoring, facial paralysis, pseudocarpal tunnel syndrome, coldness of the hands and feet, profuse perspiration, thenar, hypothenar atrophy, Raynaud disease and others.
 Porterfield JA, DeRosa C; Cadaver Dissection Videotapes-Cervical Spine”: Educational Videotapes ©1996 Rehabilitation & Health center, Inc., 3975 Embassy Parkway, #103, Akron, OH Ph:1-800-662-4043
 Herrera-Marschitz M, Utsumi H, Ungerstedt U. Scoliosis in rats with experimentally-induced hemiparkinsonism: dependence upon striatal dopamine denervation. J Neurol Neurosurg Psychiatry. 1990 Jan;53(1):39-43.
 Elster, Erin D.C.; “Upper cervical chiropractic management of a patient with Parkinson’s disease; A Case report” J Manip Physio Therap 2000 Oct;23(8):573-7
 Elster, Erin D.C.; “Parkinson’s disease:IUCCA Upper cervical Chiropractic Management of 10 Parkinson’s disease patienst ” Today’s Chiropractic, July-August 2000
 Damir Gortan MD, PhD; Division of Audiology; Dept. ENT, Zagreb University, Croatia: Transcranial Doppler sonography in patients with Meniere’s disease; Acta Media Croatia, 53 (1999) 11-14
 Mehmet Koyuncu, MD; Onur Çelik, MD; Cemal Lűceli, MD; Erol İnan, MD and Ahmet Öztürk: Doppler Sonography of Vertebral Arteries in Patients with Tinnitus ; Auris . Nasus . Larynx (Tokyo) 22, 24-28 (1995)
 Firth, James H. Professor of Symptomatology in the Palmer School of Chiropractic; Chiropractic Symptomatology – or the Manifestations of Incoordination Considered from a Chiropractic Standpoint; Chiropractic Greenbooks; Volume 7;1925:p301
 Palmer B.J.; “Fight to Climb” : Chiropractic Greenbooks; Volume 24;1950:p654
 Palmer B.J.; “The Subluxation Specific The Adjustment Specific” Chiropractic Greenbooks; Volume 18;1934:862-70