Clinical Cases

Music as Therapy: Seizures absent while playing cello. A golden clue for finding the right homeopathic remedy!

epilepsy
Written by Ian R. Luepker

Dr. Ian Luepker finds the simillimum for a young man with epileptic seizures.

While reading a children’s story to his younger brother and sister, 10-year-old Thomas suddenly stopped mid-sentence and froze…his eyes wide-open in a blank stare. Unresponsive to his siblings’ pleas to continue the story, he stared off into space for about 20 seconds, then resumed reading right where he had left off. Thomas’ parents began to observe a similar pattern during meal times. While lifting a forkful of food, he would suddenly stop midway between the plate and his mouth, freezing for several seconds before completing the movement and bringing the food to his mouth–as if there had been no interruption.

His parents first interpreted his behavior as “daydreaming” or a method of “shutting off” when he felt overwhelmed by too much sensation. But as the daily episodes became more frequent, sometimes up to four times during dinner alone, his parents realized something was amiss.

Medical investigations soon revealed that Thomas had a form of epilepsy known as “absence seizures”–named for an absence of consciousness generally lasting less then half a minute. Also called “petit mal” seizures, they are characterized by an abrupt alteration of consciousness that suddenly interferes with an ongoing activity. If walking, the person may stop and stand still like a statue; if speaking, the person’s speech may slow or stop completely.

Having an affinity for natural medicines, they also tried a number of natural therapies, with minimal success, before they contacted me for help. Thomas was 18 when I started treating him, and his seizures had shown no signs of abating over the past 8 years.

Ameliorated by Music

I began the interview with Thomas’ mother, Anne, and soon learned that Thomas was an extremely dedicated and talented cellist. Thomas played his cello a majority of his waking hours. “Music is his therapy,” Anne said. “His gross motor control has always been horrible, but his fine motor control for playing the cello is superb!”

Interestingly, Thomas NEVER had seizures when playing! Though it is well documented that, for some, music can induce seizures, for Thomas it was just the opposite. As long as he was focused on playing, the absence seizures were absent! Of course, as a homeopath I was fascinated by this idiosyncrasy because unusual symptoms can often be the key to choosing a curative remedy.

The well-known neurologist-psychiatrist Oliver Sacks has documented the powerful effects of music on brain activity in a fascinating book, Musicophilia. He writes:

“William James, the American psychologist and philosopher, referred to our ‘susceptibility to music,’ and while music can affect all of us—‘by calming us, animating us, comforting us, thrilling us, or serving to organize and synchronize us at work or at play’—it may be especially powerful and have great therapeutic potential for patients with a variety of neurological conditions.”

Thomas had always been sensitive to music. As a toddler, he would listen repeatedly to a tape of children singing folk songs. Though Thomas was born into a musical family, his parents were hesitant to start him on an instrument because he seemed to have an impatient temperament. Then, one day, he picked up his brother’s violin and began working out tunes. His parents started Thomas with cello lessons at age nine, and his first teacher immediately noted his perfect pitch and musical potential. Thomas began bringing musical scores on car trips and reading them like books. Home schooling allowed Thomas the flexibility to practice cello several hours a day, at his own initiative. Drawn to very passionate music, he began with Beethoven and worked his way to Wagner. “In short order, he joined the community orchestra, and remained its youngest member until this year,” Anne told me.

Angry, Opinionated and Disdainful

“In general he is very strong-willed, but the hardest years were between ages 7 and 13,” Anne explained. “He was much angrier then, and he fought me on everything. He would break windows and furniture, put holes in walls.” Since that time, Thomas had matured but remained irascible: “His anger is less physical now and more verbal. Sometimes he’ll step in to discipline the other children–though he is told not to.”

Anne explained that he could be argumentative and disdainful sometimes. “He has very strong opinions and lets people know about them. For example, he only plays very serious music. He disdains the fiddle music his sisters play.” Anne elaborated: “At a recent home schooling event, one of the (Catholic) Fathers, a rather loud and garrulous fellow, made a comment about Thomas’ cello. Thomas responded angrily and disrespectfully and left the room–later, on his own initiative, he did return and apologize to the priest, however. ”

Anne told me that Thomas could come across as arrogant or haughty. “He is very talkative, but he talks AT you! He lectures. He will brag about his cello abilities: ’when I was that age, I could play such and such…’ He made up a game with the younger kids–it revolves around Thomas being king.”

I asked Anne to tell me a bit more about Thomas’ reactions to sensory stimuli: “He is overloaded easily. For example, he hates shopping. He can’t stand crowds and loud noises. He’s impatient and will yell at the baby when she cries. He smells odors that don’t bother anyone else, and he’s bothered by sounds that others barely notice. His reactions are out of proportion to the situation.” Anne also noted that Thomas “runs hot, temperature-wise, and complains about the heat even when the temperature is mild. He will walk barefoot in the snow.”

Brilliant, Unshaven and Slovenly

Anne added that Thomas had difficulty functioning socially. “He doesn’t get up on time or put on clean clothes. His beard has come in irregularly, and though we’ve mentioned shaving, he’s not too keen on the idea. If we didn’t nag him, he’d never take a shower! He’ll fall into bed in whatever he is wearing. He just doesn’t care what others think, and he doesn’t like to be told what to do.”

Thomas was talented in many other areas, though. “He has a phenomenal memory, reciting poetry by rote, ” Anne noted. “He writes well, though somewhat pedantically. He taught himself electronics, following an old manual his uncle gave him. He likes to read fix-it manuals, and he has been helpful in repairs around the house.”

Playing music helps me enter that world of emotions

I then interviewed Thomas and asked him to describe his epileptic experience: “During my seizures everything looks unreal, like a picture with too much light on it. It is an altered state of consciousness. I am not able to fully react, and everything seems different. I could move out of someone’s way, but that is about it.”

But Thomas was most passionate when talking about music:  “I love classical music, playing and listening to it. Brahms and Beethoven are my favorites. Playing music well is like a means of communication with the Supreme Being. It brings up all kinds of feelings–melancholic, exaltation…it helps me to escape. When things are difficult, it helps me escape into a beautiful world–a more heroic place where everything is good, noble, and beautiful. Beethoven’s Ninth [Symphony] purifies you so you can rise to newer things. I have a hard time being with people socially–it interrupts my thoughts. Playing music helps me get to that world of emotions. Like Schiller’s ‘Ode to Joy,’ sung by a choir!”

I asked Thomas to tell me more about his “world of emotions”: “Sometimes I feel like I am sunk in a medium depression. Nothing can happen. Everything is extremely ordinary and there isn’t any good in anything. Very ignoble.”

“What does ignoble mean to you?” I asked. “The man who lives simply to exist,” he replied. “Doesn’t produce art or anything. Just exists for oneself. If you have religious conviction, you can produce art, we create in God’s image. I work hard, I try to manifest my talent, I desire to be better than everyone else.”

Thomas described a history of bright red nosebleeds, sometimes daily, often after sneezing. During allergy season, he suffered greatly with chronic, intense sinus pain and congestion. He was prone to recurrent left-sided headaches, possibly related to his allergies. He also showed me some small red spots on his skin that he called blood blisters (actually cherry angiomas), “spread evenly on my arms and legs, some on my torso, and mainly on the left side.” He struggled with constipation; sometimes there would be blood on his stools as a result of straining. Thomas also complained of insomnia: “I can’t seem to wind down, it makes me upset that I will be tired in the morning.”

In closing, I asked Thomas if there was anything he’d like to change in his life: “I’d like to be less irritable,” he responded. “It makes me irritable to have to come out of my own thoughts to be with other people. I’d rather be alone without interruption.”

Music expresses the quintessence of life

In reviewing Thomas’ case, several characteristic symptoms stood out, and I took time to write up my assessment of them. Most striking was how Thomas’ seizures abated while playing music! From a homeopathic perspective I gave due weight to the homeopathic repertory rubric, “ameliorated by music.” But from a neurological perspective, I wondered, awestruck: How are the neurological pathways that are activated during an absence seizure temporarily blocked while Thomas played music?

While contemplating this question, I read a quote by German philosopher Arthur Schopenhauer in Sacks’ book Musicophilia that shed some light on Thomas’ internal experience of playing music. Schopenhauer wrote, “The inexpressible depth of music, so easy to understand and yet so inexplicable, is due to the fact that it reproduces all the emotions of our innermost being, but entirely without reality and remote from its pain….Music expresses only the quintessence of life and of its events, never these themselves.” I had a strong sense that Thomas’ music touched, healed, and integrated him emotionally for similar reasons.

Thomas’ strong will and argumentative nature stood out for me as characteristic symptoms, as did his tendency toward holding strong opinions. His haughtiness and tendency to “talk at” people seemed pronounced, and given these tendencies, a desire to play king seemed unsurprising yet characteristically unique. His strong religious feeling, taken deeper with music, seemed remarkable for an 18-year-old, as did the manner in which he contrasted an ignoble, selfish existence, with the noble life aligned with religious conviction.

Thomas’s self-described irritability and desire to be alone with his uninterrupted thoughts also helped orient me toward choosing a remedy, as did his general tendency to run hot temperature-wise and his trouble falling asleep. His cherry angiomas on his torso and arms were also noteworthy, as such skin growths are common in middle age but uncommon in the teen years.

Remedy differentiation, selection, and mineral salts

In considering different remedies for Thomas through repertorizing the above symptoms and tendencies, three medicines initially surfaced: Platina, Sulphur, and Aurum. Platina is a homeopathic remedy made from Platinum (which appears in the sixth row of the Periodic Table of the Elements). This remedy is indicated for extremely idealistic people who compensate for feelings of disappointment by becoming contemptuous, haughty, and narcissistic. They can have a tendency toward depression, as Thomas did. According to homeopath Rajan Sankaran in his Soul of Remedies: “Platinum is the ‘Queen’–she must carry herself regally, show herself superior. Everything about her is rare, valuable, spiritual, and intellectual….being so special and rare, she feels left out in a world of ordinary people–she cannot mix or mingle with them.”(p.165) People needing Platina perceive themselves as noble, and they disdain what is common, ordinary, and ignoble. So far, much of this seemed to match Thomas’ case. However, people needing Platina have an underlying fear that unless their nobility is made known, they will be alone and isolated. By contrast, Thomas preferred to be alone–left uninterrupted with his own thoughts. Also, Platina’s physical and general symptoms (such as numbness, painful sensitivity of sexual organs, and feeling better from weeping) didn’t have enough of a resonance with Thomas’ symptom picture to merit this remedy.

Homeopathic Sulphur repertorized strongly for Thomas’ case as well. His general slovenliness and lack of interest in bathing, changing his clothes, or shaving pointed in the direction of Sulphur. Both idealistic and mechanical, with a tendency toward running on the hot side and having cherry angiomas, Thomas reflected several qualities of Sulphur. People who need Sulphur can come across as scornful and overly critical if feeling embarrassed. They can hold very strong opinions. These behaviors arise when their ego is wounded, and they treat others in a manner consistent with what they are feeling about themselves. Sulphur seemed to be a good fit for Thomas in many ways; however, his disdainfulness didn’t seem to arise from embarrassment or a wounded ego, but rather from an inherent sense of nobility.

Aurum metallicum, a homeopathic remedy made from the precious metal gold, was strongly represented in the repertory rubrics “ameliorated by music” and “religiosity.” It is indicated for patients with over-reactivity of the senses, great ambition, explosive anger, and an exaggerated sense of duty. Aurum is also one of the first remedies considered when treating melancholia (depression). People who need Aurum tend to set the bar very high with regard to responsibility; they often have uncompromising principles related to strong religious feelings. Aurum also matched many of Thomas’ physical symptoms–his epilepsy, nosebleeds, sinus issues, and cherry angiomas.

I felt there were enough qualities of both Sulphur and Aurum metallicum in Thomas’ case to merit looking for a remedy prepared from a mineral salt that included both Sulphur and Aurum. In fact, such a remedy exists–Aurum sulphuratum, prepared from the mineral salt auric sulfide. Auric sulfide is naturally occurring–the two component minerals being brought together by an ionic bond–and it is proven as one homeopathic remedy. Choosing a remedy in this way is called a “synthetic prescription,” and it’s used when there are two mineral remedies that both share a resonance with the patient’s symptom profile and happen to have been proven as a single mineral salt. This is different from giving two remedies at the same time in combination (which is not considered classical homeopathy).

Music, Brains, & Repertory Rubrics

Music has a powerful effect on our brains. So much so, that the eminent author and neurologist/psychiatrist Oliver Sacks has said: “Whenever I get a book on neurology or psychology, the first thing I look up in the index is music; and if it’s not there, I close the book.”

Since the recurrent seizures of epilepsy are attributed to an abnormal pattern of electrical activity in the brain, it makes sense that music could have an impact on seizures as well. It has long been documented that music (as well as other stimuli, such as flashing lights) can trigger seizures in a small percentage of people with this condition. For Thomas, however, playing his musical instrument was a surefire way to keep his seizures at bay.

What do our homeopathic repertories have to say on this subject?

Van Zandvoort’s Complete Repertory has a rubric, “Generalities, Convulsions, Music ameliorates,” which lists two remedies: Calcarea carbonica and Tarentula. Neither of these remedies had symptom profiles that fit Thomas’ case well. Another relevant rubric is, “Generalities, Music ameliorates,” with 15 remedies listed: lach., thuj., am-m., aur., bufo, cann-s., croc., ign., mag-p., mosch., sul-ac., sumb., tarent., tub., zinc-val. Another important rubric is, “Mind, Music ameliorates,” with 16 remedies listed: TARENT., Aur., thuj., am-m., ambr., androc., anh., carc., cupr., hydrog., mang., merc., nat-m., sul-ac., sumb., tub.

It is interesting that Aurum metallicum, the homeopathic remedy prepared from gold, figures prominently in both of these rubrics.

As good as gold

Ultimately, I decided on the remedy Aurum sulphuratum for Thomas. I’m grateful to Terje Wulfsberg for his book, Three Pieces of Gold, in which he provides materia medica for Aurum muriaticum-natronatum, Aurum arsenicum, and Aurum sulphuratum–three homeopathic remedies made from mineral salts that contain gold. His contribution to the understanding of the Aurum salts has been very helpful in my practice, and his description of Aurum sulphuratum convinced me that it was a better fit for Thomas’s case than either Aurum or Sulphur alone. Besides having many symptoms in common with both Aurum and Sulphur, Aurum sulphuratum’s indications contained the remaining aspects that I perceived in Thomas: primarily his censorious and quarrelsome need to impose his strong opinions, a mania for playing music, an extreme irritability, and a willingness to step into a heavy-handed role of leadership (i.e., playing king!). Wulfsberg writes that Aurum sulph patients demonstrate “…a  directness and aversion to company. The Aurum sulph patient is an open and direct person, who clearly states his opinion and doesn’t hide his emotions. He usually is powerful and energetic. You often find a kind of roughness in his way of speaking, from which you can feel that he has the strength to impose himself if necessary. Aurum sulph patients always prefer to be alone. A distinct aversion to company is a must for the prescription of this remedy.” Aurum sulph also fit Thomas’ constipation, frequent nosebleeds, left-sided headaches, and difficulty sleeping.

Liquid sunshine lifts Thomas’ spirits!

I prescribed Aurum sulphuratum LM1 for Thomas to take daily. I prefer using liquid remedies because, in my experience, they are less likely to induce an aggravation (i.e., a temporary worsening of symptoms in the course of healing). And an LM1 is a very safe, conservative, low potency with which to begin treatment.

Six weeks later when Thomas returned for a follow-up visit, he excitedly told me that while his seizures still occurred daily, they had lessened by at least 50% in frequency. Both his parents had observed this, and they commented independently on the diminished frequency of absence seizures. Anne shared that Thomas seemed calmer, less irritable with his siblings, and happier. His sinuses had improved by about 30%,and his almost daily nosebleeds had abruptly stopped! Since Thomas seemed to be making good progress, I asked him to continue taking the remedy in the same manner.

Seven months into treatment, Anne observed that Thomas’ hygiene had definitely improved and he was taking more showers without reminders. Thomas explained to his mom, “I couldn’t stand myself anymore!” Also, Anne commented, “He usually gets colds and flus at this time of year, but he hasn’t yet!” Thomas exclaimed that his seizures were a lot less frequent: “Usually when I am bored they occur.” He also noted that his sinus congestion had diminished. Since Thomas was still making good progress, we continued with the Aurum sulph LM1, daily.

Eleven months into treatment at a follow-up visit, Thomas told me that at one point during the previous month, he hadn’t had a seizure for an entire week! What a great result! Not long after that, however, I felt his progress in general had “plateaued,” so I increased the potency of Aurum sulph to LM2.

Fourteen months into treatment, Thomas reported that his allergies had returned. “Though not as bad as they had been in past years,” his father commented. Additionally, Thomas’ nosebleeds had returned. However, Anne was happy to report that his seizures had lessened considerably–“he has only had one or two this week!” Although I was happy his seizures had declined so much, I took the return of his allergies and nosebleeds as a signal that we needed to increase the potency of the remedy. So I asked Thomas to begin taking daily LM3 doses of Aurum sulphuratum.

I continued to follow up with Thomas every three months or so, increasing the potency of Aurum sulphuratum whenever it seemed that his progress had plateaued or that some of his original symptoms had begun to creep back.

Now over four years into homeopathic treatment, Thomas is taking Aurum sulph LM10 a couple times per week. He is successfully attending college and flourishing with friends, classmates, and a roomate! Anne tells me: “Thomas is making friends and has even become popular! People see him as a kind person! I never would have believed this could happen. The change in him is absolutely incredible!”

Here was a young man who, before homeopathic treatment, wanted to be “alone with his thoughts” and became irritated when others wanted to talk with him. He would lord over his siblings and bark at the baby when she cried. Now his mood is much more even, and he’s enjoying the camaraderie of college! His seizures have diminished considerably to the point where they are barely noticeable, happening just a couple times per week rather than many times daily, and only lasting a few seconds when they do occur. His nosebleeds are gone, his allergies and sinus problems are much improved, and he is rarely constipated. Thomas no longer has difficulty falling asleep at night and he wakes feeling well-rested. Not only has this enhanced his general well-being, it has had a positive impact on his seizures since they were sometimes triggered by tiredness. And, ever the consummate musician, Thomas continues, daily and diligently with the cello!

Peace through homeopathy and music!

It is heart-warming to see a young man like Thomas, with so much musical virtuosity, blossom into adulthood and make a smooth transition to college! Thanks to homeopathy and a supportive family, he has overcome physical, emotional, and social obstacles that often appeared insurmountable. Thomas’ case has also deepened my own appreciation for the power of music–and its great potential to heal the body and the mind!

About the author

Ian R. Luepker

Ian Luepker, ND, DHANP is a homeopathic and naturopathic physician licensed in the states of Washington and Oregon. Dr. Luepker practices in Ashland, Oregon and is co-author of A Drug-Free Approach to Asperger Syndrome and Autism: Homeopathic Care for Exceptional Kids. He treats patients in person, by phone, and by video-conferencing. He welcomes questions and can be reached by phone at : 541-482-2824 or via email at [email protected]

5 Comments

  • A very well presented case. I always feel that a well-written case will enable other practitioners to understand and use a remedy. The details from the intake as well as the discussion of the literature allow me to understand why he chose this remedy over all other possibilities. Lengthy follow up and thorough discussion of curative response also make this a beautiful teaching case.
    Kudos, Dr. Luepker.

  • Dear Dr. Luepker,
    Congratulations on a great and well-written case!

    Also, thanks for the valuable suggestion regarding Terje Wulfsberg’s book, “Three Pieces of Gold”. It sounds like a helpful textbook to have and study.

    Best wishes,
    Bob Signore, DO

  • According to Hahnemann, wouldn’t a return of original symptoms (like that experienced at the end of LM2) be an indication that this remedy in the LM has finished its course? And should be discontinued, to see if it has done all it can, or if another Rx is needed?
    (Aphorism 161, 6th ed. Organon)

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