Integrating Cranio-Cervical Neuromyofascial Continuity With Body-Wide Function in Kimmerle Anomaly: An Osteopathic Case Report.

Kimmerle anomaly is a congenital bony variant of the atlas vertebra that can, in rare cases, be associated with neurological and vascular symptoms. Although often asymptomatic, its clinical significance increases when presenting alongside persistent cranio-cervical pain and associated symptoms. This case report aims to describe the clinical presentation and osteopathic management of a young adult with symptoms potentially secondary to Kimmerle anomaly, highlighting the role of osteopathic manipulative treatment in a complex diagnostic context. A 19-year-old male presented with chronic cranio-cervical pain, right-sided neck and trapezius discomfort, tension-type headaches, dizziness, and episodic right-ear tinnitus and hypoacusis. Symptoms began at the age of 16 years and persisted despite various conservative interventions. Imaging revealed a complete Kimmerle anomaly. Neurological examination by the osteopath indicated altered sensation and sensory deficits. The patient underwent five osteopathic manipulative treatment sessions using a whole-body approach, focused on somatic dysfunctions, including, but not limited to, the upper cervical spine and its related fascial system connections. Techniques were chosen based on clinical evaluation and adapted to the patient's individual dysfunction patterns. No adverse effects were reported. At follow-up, the patient reported a reduction in pain, improved quality of life, and resolution of vestibular and auditory symptoms. This case highlights the potential value of osteopathic assessment and treatment in patients with persistent symptoms potentially linked to Kimmerle anomaly. The integration of osteopathic care into interdisciplinary diagnostic pathways may enhance management and improve outcomes in complex cases where structural anomalies coexist with functional disturbances.