ICU – “I See You” Podcast
Chiropractic Neurology
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In this episode, we talk about how the brain interacts with the body, and one specialized type of healthcare provider who studies this. Chiropractic neurology, also known as functional neurology, is a specialty that branches from the traditional chiropractic methods. You might think of a traditional chiropractor as someone who performs manual adjustments on the neck and spine. Chiropractic neurologists aim to optimize neurological function by leveraging neuroplasticity, the brain’s ability to change and adapt. Chiropractic neurology offers a holistic approach for assessment and therapeutic interventions that may benefit patients with vestibular symptoms. By examining how brain function intersects with other body systems, chiropractic neurology can begin to unravel complex health conditions. We learn about what chiropractic neurology is and what it isn’t by speaking with a chiropractic neurologist and one of his patients.
Guests
Dr. Daniel Demian has a Bachelor’s degree in Kinesiology and a Doctor of Chiropractic degree, with postdoctoral studies in Chiropractic Neurology through the Carrick Institute for Graduate Studies. His training and personal experience allow him to evaluate and rehabilitate people from a brain-based perspective. He and his team use cutting-edge equipment and years of experience to test and interpret specific markers of the brain and nervous system. Based on these tests, they design treatment plans that integrate tools and modalities to harness neuroplasticity. Daniel is involved in research, technology, consulting, and continued learning in these fields. His goal is to bring awareness and restore hope to people who are suffering from vestibular dysfunction but have yet to find answers to help them recover.
Brian Kashin is an anesthesiologist from Toronto, Canada. In 2016, he was diagnosed with mycotoxin illness due to chronic exposure to mold, systemic candida, bilateral vestibulopathy, and oscillopsia. After therapy for his environmental illnesses, including anti-fungals, binders, and gut restoration, he was able to start vestibular rehabilitation. He has been working with Dr. Demian since March, 2024, in conjunction with an ENT and a Kinesiologist. He is continuing to improve and has been able to start playing pickleball (fairly competitively, I might add) and regain significant functional abilities and activities of daily living.
Summary
Brian’s Vestibular and Environmental Health Journey
Brian describes his illness as a long, insidious process that started well before his eventual diagnosis. His earliest symptoms were not classic dizziness, but insomnia, non-restorative sleep, and profound fatigue. Over time, more overt balance problems emerged. One key incident occurred while cycling: after going over train tracks, he suddenly couldn’t stabilize his gaze, veered off to one side, and fell. The episode wasn’t clearly traumatic, but it signaled that something was wrong in how his brain and balance systems were working.
With his medical background, Brian systematically considered and ruled out many common causes. He underwent a stress test, evaluated potential metabolic issues such as hypo- or hyperglycemia, and considered cardiac arrhythmias. These standard investigations did not explain his imbalance.
He was eventually seen by an otologist at a tertiary care center in Toronto, where he received diagnoses of oscillopsia (the sensation that the visual world is bouncing or moving) and bilateral vestibulopathy, as well as a label of atypical Ménière’s disease. The picture, however, remained murky. He notes that oscillopsia is often associated with a clear structural or otolithic cause, and in his case, things did not fit a simple pattern. The diagnosis of bilateral hypofunction, in hindsight, may have been something of a red herring.
Another major piece of the puzzle was chronic mold exposure and mycotoxin illness, along with systemic Candida. At the time—2016—testing for mold-related illness was limited and controversial. Brian highlights that mold can present with widely variable symptoms. Some people simply leave the environment and recover; others become colonized, requiring a much more complex process of treatment and eradication. For him, moving out of the moldy home triggered the realization that environmental factors were likely playing a crucial role.
Over time, with therapies including antifungals, binders, and gut restoration, he became “systemically better”—well enough to embark on vestibular rehabilitation. He also worked with an ENT and a kinesiologist, gradually regaining function. A major milestone was being able to return to sport, specifically pickleball, a visually demanding game that requires fast, accurate tracking of a moving ball while moving one’s body and head in space. For Brian, the ability to play pickleball at a fairly competitive level became a concrete marker that his vestibular function was meaningfully improving.
Despite progress, he still had significant limitations in complex environments that pushed his visual and proprioceptive systems. That’s when he sought out chiropractic neurology with Dr. Daniel Demian, aiming not just for symptom reduction, but to restore higher levels of functional performance and quality of life.
What Chiropractic Neurology Brings to Complex Vestibular Cases
Dr. Daniel Demian explains that chiropractic neurologists are licensed chiropractors with extensive postgraduate training in neurology, typically 300+ hours or more, depending on subspecialty. While traditional chiropractic care tends to focus on the spine and joints and often emphasizes manual adjustments, chiropractic neurology broadens the lens to include:
- The brain and nervous system
- Sensory integration between vision, vestibular input, and proprioception
- The use of neuroplasticity to restore or optimize function
In practice, this means that chiropractic neurologists don’t always adjust the spine; they integrate eye movement therapies, vestibular rehabilitation, sensory integration exercises, and manual therapy into a targeted plan designed around each patient’s specific functional deficits.
Demian emphasizes that many of his patients are “uniquely atypical.” They often arrive after having seen multiple providers—ENTs, neurologists, physical therapists, functional medicine practitioners—and either:
- Have improved but hit a ceiling where certain functions never return, or
- Have not improved at all because a key underlying issue has been missed or not fully addressed.
He frequently sees overlap between vestibular, autonomic, and cervicogenic (neck-related) symptoms. Patients may not present with “textbook” vertigo; instead, they have subtle sensory integration problems involving the visual, vestibular, and cervical systems. In these cases, standard imaging and vestibular tests might appear normal or show abnormalities that don’t fit familiar patterns, precisely because the problem lies in how the brain is weighting and integrating multiple sensory inputs, a process known as sensory weighting.
Conditions Well-Suited to Chiropractic Neurology
Demian reports good outcomes with:
- BPPV, including chronic forms
- Vestibular migraine, often in co-management with other providers
- Post-concussion dizziness
- Some forms of orthostatic intolerance–related dizziness, when the problem is more about spatial perception than a purely structural issue
- Uncompensated vestibulopathies, especially in chronic stages, where the focus shifts to function and life participation
By contrast, conditions where there is an acute structural lesion—such as vestibular schwannoma, active Ménière’s disease, acute labyrinthitis, or clearly vascular causes of dizziness—are not primary targets for his care. In those situations, he prioritizes referral and collaboration, ensuring that acute medical or surgical management is handled by the appropriate specialists before or alongside any neurorehabilitative approach.
How Assessment and Treatment Differ From Traditional Approaches
A key distinguishing feature of Demian’s work is depth and specificity of testing, followed by equally precise treatment tailored to those findings.
On the assessment side, in addition to detailed history and neurological examination, his clinic uses:
- Video eye movement tracking (VNG/VOG) to assess eye movements with and without visual targets
- Static and dynamic posturography and sensory organization testing to understand how patients use vision, vestibular input, and proprioception for balance
- Clinical tests that attempt to tease apart cervical, vestibular, and visual contributions to dizziness and imbalance
Examples include:
- Neck torsion tests, where the body is rotated under a stable head to stress the neck without activating the vestibular system. Worsening symptoms here point toward a cervicogenic or proprioceptive component.
- Cervical joint position error testing, where a patient tries to return their head to neutral with eyes closed, often using a head-mounted laser. Difficulty here indicates impaired proprioception—an inability to sense where the head is in space.
- Simple but revealing maneuvers like pressing the neck (“neck hug”) or leaning against a wall to see if added proprioceptive input stabilizes symptoms—more likely in cervicogenic/proprioceptive dizziness than in classic positional BPPV.
On the treatment side, Demian stresses three core principles:
- Specificity – Targeting the exact sensory and neural pathways that are underperforming.
- Dosage – Carefully titrating intensity and duration so the brain is challenged but not overwhelmed.
- Prioritization – Deciding which sensory system or integration problem to work on first, and in what sequence.
Manual therapy can play an important role, particularly when there is a cervical contribution. But it rarely stands alone. Right after improving neck function, for example, he often adds gaze stabilization, habituation exercises, or controlled visual motion exposure, so that the neck’s improved proprioceptive signals are correctly integrated with vision and vestibular input.
In Brian’s case, objective testing showed that his eye tracking and ability to hold on to visual targets—both in stillness and during movement—were severely impaired. Over time, he progressed from severely reduced performance to healthy, normative ranges. That improvement was not just on paper; it translated into real-world abilities like playing pickleball, tracking fast-moving targets, and navigating dynamic environments with much greater confidence.
For Demian, success is measured not only in test scores but in quality of life: patients getting back to sports, work, and daily activities they value. Brian’s story illustrates how complex, overlapping problems—mycotoxin illness, bilateral vestibular dysfunction, and neuroinflammatory effects on the nervous system—can, with the right combination of medical treatment and targeted neurorehabilitation, be disentangled enough for the brain to relearn how to switch, adapt, and function at a high level again.
