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OMT for TBI: A Case Report Showing Improvements in Vision, Mastication, and Post-Traumatic Headaches

Journal: The AAO Journal Date: 2025/06, 35(2):Pages: 9. doi: Subito , type of study: case report

Full text    (https://aaoj.kglmeridian.com/view/journals/aaoj/35/2/article-p5.xml)

Keywords:

case report [705]
male [763]
OMT [3746]
osteopathic manipulative treatment [3766]
TBI [5]
traumatic brain injury [20]

Abstract:

Introduction: Traumatic brain injury (TBI) results from a physical force to the head, with varying degrees of severity, that can lead to significant difficulties with speech, chewing/swallowing, cognition, vision, headaches, sleep, and decreased quality of life and function. Case: A 22-year-old male presented to the outpatient Physical Medicine and Rehabilitation (PM&R) clinic. He was referred for his vision changes, bilateral trismus, and headaches. The patient sustained a TBI 3 years prior, complicated by bifrontal craniotomy and multiple facial fractures requiring orthopedic fixation. His exam showed left eye ptosis, facial asymmetry, and decreased mouth opening of 2cm. Balanced membranous tension (BMT) was used to target restrictions in his frontonasal suture, maxillary suture, occipitomastoid suture, and temporal bone. Direct inhibition was utilized to the hypertonic muscles of the jaw, particularly the lateral pterygoids. Myofascial release and muscle energy were used for his hypertonic neck musculature. Results: Over a total of 6 sessions in 10 weeks, the patient had both subjective and objective improvements. His vision improved from 20/50 in his left eye to 20/20. For his trismus, the patient’s mouth opening doubled to 4cm, which improved his speech and mastication. His Visual Analogue Scale (VAS) pain score for headaches decreased. The patient was able to stop all medications by his last treatment – previously taking acetaminophen, gabapentin, ibuprofen, methocarbamol, and ramelteon for headaches, jaw pain, and sleep. His facial asymmetry and ptosis also improved. Discussion: Our case study suggests that the use of OMT after TBI can treat multiple symptoms when addressing somatic dysfunctions in the head and neck. Future areas of research could investigate earlier introduction of OMT for TBI, such as during acute rehabilitation stay.


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