Which of the following is an indication for PRM?

• A. Cranial neuropathy
• B. Skull fracture
• C. Acute intracranial bleed
• D. Coagulopathy

Answer: (A)

PRM is a gentle cranial manipulation aimed at releasing restrictions around neural tissues to improve cranial nerve mobility and function. It’s particularly considered when there is cranial nerve neuropathy, where symptoms reflect nerve dysfunction that may respond to improved neural mobility and reduced dural tension, rather than a direct, acute injury.

The best indication among the options is cranial neuropathy because it represents a functional nerve issue that PRM can help address with minimal, non-invasive technique. In contrast, skull fracture, acute intracranial bleed, and coagulopathy are contraindications; manipulating the skull in those situations risks worsening injury or bleeding and is avoided until the patient is stabilized.