Nonpharmacologic Management of Recurrent Painful Ophthalmoplegic Neuropathy: A Case Report

Recurrent painful ophthalmoplegic neuropathy (RPON) is a rare neurologic disorder characterized by headaches and ocular cranial nerve paresis with no consensus on optimal treatment. While pharmacologic treatments are commonly used, limited research has explored nonpharmacologic options. A 36-year-old woman with a multi-year history of episodes of RPON lasting several months presented to a chiropractor with a week-long episode of headache and diplopia unresponsive to oral steroids and sumatriptan. Spinal manipulation and acupuncture were administered over six weeks, leading to complete symptom resolution. This is a case of RPON managed successfully with chiropractic care and acupuncture, suggesting a potential beneficial role of these therapies. Given the limitations of a single case, further research is warranted to determine the effectiveness of these therapies for RPON.