|
||||||||||||
| ||||||||||||
Forums
Courses
Shop
Diseases
Articles
Journal
Directory|
|
|||||||||||||||||||||||||||||||||||||||||||||
Cured Cases |
|||||||||||||||||||||||||||||||||||||||||||||
|
|
|||||||||||||||||||||||||||||||||||||||||||||
| Hpathy Ezine - December, 2006 | |||||||||||||||||||||||||||||||||||||||||||||
A Case of Cerebro Vascular Accident (CVA)-- --Dr. Niranjan Pai, Dr. Navin Pavaskar |
 |
||||||||||||||||||||||||||||||||||||||||||||
| This is the case of a male, 50 years of age, who presented at the Palghar Hospital OPD on 20th August ’05 with tingling/numbness of the upper and lower limbs on the left side. This had begun 10 days earlier and was progressively getting worse. It began with weakness of the limbs on the left side and he was now unable to move them. An episode of severe anxiety and fear had precipitated this onset of symptoms. It had progressed further and now he had slurred speech and was laughing immoderately. He also had a strong feeling of being intoxicated ++. Along with this there had been a recurrent headache that tended to be worse in the morning, around 9-10 am. 2 months earlier he had developed hypertension. The symptoms at that point were a similar tingling and numbness on the left upper and lower limbs. This too, was precipitated by an episode of fear. He was put on anti hypertensive medication which helped and he stopped this on his own after a while. There were no other CNS symptoms of unconsciousness, projectile vomiting, convulsions, fever or head injury. There was no Past History of diabetes, or ischemic heart disease as possible precipitating factors. On Examination:
At this point in the OPD we had to decide whether this case needed to be admitted as inpatient for homeopathic management. We follow a set of criteria to make this decision for all cases, including this one. Here are the criteria that indicate mandatory in-patient admission for a homeopathic patient.
In this case, hospital admission was a necessity for further investigations and management to be carried out. Investigations:
E.C.G. : L.V.H. Pattern CT SCAN – BRAIN (Pictures can be viewed in the attached slide presentation) E/o ill-defined hypodense lesion seen in the Rt high parietal lobe involving centrum semi ovale, mostly suggestive of recent non-hemorrhagic infarct in Rt MCA area. E/o multiple lacunar infarcts in Rt internal capsule & basal ganglia. E/o old small size infarct in Lt anterior limb of internal capsule in Lt MCA area. Periventricular white matter ischemic changes seen. FINAL DIAGNOSIS: LT SIDED HEMIPLEGIA, secondary to Right MCA (Middle Cerebral Artery) non-hemorrhagic infarct involving the parietal lobe of the cerebrum. HYPERTENSION HYPERLIPIDAEMIA Management: Once these preliminary medical observations are complete, we must now appraoch the case from the homeopathic standpoint for appropriate homeopathic management and care. In fact the homeopathic diagnosis is an integrated ongoing process even through the medical work being done above. What is obvious from above, is that there already exists a chronic process going on over many months that has precipitated now as a hemiplagia (stroke). This is an acute complication of chronic disease. Our plan was to decide on the acutely indicated remedy to overcome this acute picture of symptoms, followed by the constitutional remedy. This is how we reasoned it out: Acute remedy: There was a distinct change in the susceptibility during the acute episode that presents with new symptomatology, a clear causative factor and characteristic modalities and concomitants. These were indications for an acute remedy. Constitutional remedy: Is expected to continue with healing of the infracted area of the brain. It is also expected to deal with the underlying causes of hypertension and hyperlipidaemia so that such episodes will not recur. In addition, the constitutional remedy must deal with the excessive tendency to be morbidly anxious and fearful over circumstances. With this philosophical understanding of our approach, we concentrated on the acutely presenting totality which was as below:
These were the rubrics chosen. Our next step was to consider which repertorization approach was appropriate to this case given the characteristic picture. Since there was characteristic sensation, modalities, concomitants, and causation, we chose the Boenninghausan’s approach for repertorization. The remedies that came up were: Nux Moschata, Gelsemium, Opium, Rhus tox, Causticum. Furthur discussion was required to decide on the appropriate remedy. Along with this we also made an assessment of the Susceptiblity:
Hence the choice of posology was: Low potency with frequent repetition. The next step was to evaluate the underlying Miasm:
The miasm is SYCOTIC The final choice of remedy was Gelsemium 30C. Follow Up: 21/08/05:
Plan: Gelsemium 200 QDS
Continue: Gelsemium 1M QDS.
At this stage we also considered the Chronic totality for a similimum so as to be able to appropriately begin with chronic treatment when clinically indicated. Here is the chronic picture: The patient as a person:
The Totality based on this information is:
The constitutional remedy chosen was Causticum. Follow up: 29.8.05
14.9.06
His power continued to improve and he was normal with blood pressure well within control, anxiety considerably lessened. His lipid levels also began to reduce in time. The healing and resolution took place over a period of just a few weeks – which is remarkable in itself. That the patient chose to begin homeopathic treatment right at the outset was an important reason for such a quick resolution, before any other medication interfered with response of the vital force to an appropriate simillimum. This is a clear example of how serious cases can be managed effectively on homeopathic treatment and management without any need for allopathic interventions, provided we have our principles of remedy choice and management clearly in place. Click here to download the powerpoint presentation of this case.
Dr. Niranjan Pai, Medicine Part II with Dr. Navin Pavaskar Medicine Department |
|||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||
