The AAO Journal, 2025/06, 35(2):5. doi: 10.53702/i2375-5717-35.2.5, type of study: ,cr,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

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

Keywords:

autoimmune disease [7]
case report [736]
cranial dystonia [1]
exocrine glands [1]
female [655]
inflammation [32]
OMT [3925]
osteopathic manipulative treatment [3946]
Sjögren&rsquo [1]
s Syndrome [45]
trigeminal neuralgia [9]
women [608]

Abstract:

Background: Sjogren’s Syndrome (SS) is a chronic disease characterized by inflammation of exocrine glands; however, up to 20% of patients with SS have central or peripheral neurologic symptoms. There are case studies to support the use of osteopathic manipulative treatment (OMT) in patients with dystonia of neurologic origin, but there is sparse research on the use of OMT in patients with dystonia secondary to SS. Case: A 64-year-old female patient with SS and trigeminal neuralgia presents with painful cranial dystonia. After persistent symptoms despite medication, physical therapy (PT), occupational therapy (OT), and speech therapy (ST), she was referred to Osteopathic Neuromuscular Medicine clinic. She had developed many compensations in PT, OT, and ST, which improved presenting symptoms, particularly speaking and eating, but resulted in painful muscle hypertonicity. On initial presentation, the patient endorsed significant face, neck, upper back, and chest pain. Her physical exam and osteopathic structural exam were significant for R condyle and sacrum compression as well as hypertonicity of the right masseter, right lateral pterygoid, and bilateral trapezius muscles. She was treated primarily with osteopathic cranial manipulative medicine, balanced ligamentous tension, myofascial release, muscle energy, and counterstrain. Results: Over six appointments, she endorsed improvement in her dystonia and decreased pain and tension, namely improved tongue control and less pain with speaking. The compression of the R condyle and sacrum resolved. The hypertonicity of the right masseter, right lateral pterygoid, and bilateral trapezius muscles was persistent though improved. During this period, she continued PT, OT, ST, and a prednisone taper. Conclusion: OMT benefited this patient with neurologic sequelae secondary to SS. Other patients with SS could greatly benefit with OMT as a component of their multidisciplinary care.