This is a case of behavioural disorder in a 4 year old boy with slurring of speech. He also suffers from tendency to cough and cold.
Date : 25/09/2015
Presenting complaints:
- Behavioural :
- Violent anger- bites, hits, shouts, breaks and throws things in anger.
- Unable to concentrate in school.
- Hits and bites other children.
- Tendency to catch cold easily with fever.
Aggravating factors being change of weather, cold food and drinks, getting wet.
- Speech is slurred and unclear. Unable to pronounce words clearly.
Generals:
Appetite: wanting
Thirst: thirstless
Craves: nothing significant
Aversion: Nothing significant
Sleep position: on sides
- Startles in sleep
- Talks in sleep
- The child stiffens his hands and legs on waking and also when he was afraid.
Perspiration – More on scalp
Stool- Nothing significant
Urine- Nothing significant
Mind:
Apart from being aggressive as mentioned above, the boy was extremely obstinate. He always wanted things his own way. If he did not get that, he would get angry and violent.
He disliked going to school. Found studying difficult. Could not understand and comprehend well.
The child had marked fear of darkness.
He had a habit of touching everything.
Curious
On observation:
- The child was restless. He was unable to sit in one place. Constantly doing something or another.
- His lower eye lids were puffy (post surgery for retinopathy with prematurity). This swelling would increase anytime but was more or less persistent.
- Elongated uvula
Mother’s history during pregnancy:
The mother was 34 years old. She was a multipara with a history of ruptured ectopic pregnancy in the past. She was a known case of hypertension since 4 years.
She would bleed intermittently since the first month of pregnancy.
During the 29th week of gestation, the mother was slapped by an insane lady while walking on the road. This incident frightened the mother immensely. She went into labour the same night and delivered.
Birth History:
Preterm Normal Delivery
Birth weight: 1.10 kg
He had Respiratory distress syndrome with early onset of sepsis after birth. He underwent blood transfusion.
At 4 weeks of birth he suffered from Pneumonia.
The child was in the NICU until 2 months after birth.
He was operated on thrice for retinopathy of prematurity with laser.
Family History:
Mother: hypertension
Older sister: past history of pulmonary tuberculosis
Repertorial totality:
Probable remedies:
Belladonna, Opium, Hyoscyamus Niger
Final remedy:
Hyoscyamus Niger 30 twice a day
Follow up:
2/10/2015
Cough- since 2 days
Cough< lying down + ; unable to sleep
< while eating
< crying
Paroxysmal cough +
RX:
Drosera 1M
Every 3 hours/ 4 days
- 07/10/15
Cough – >>
Behavioural problems: SQ
RX:
Hyoscyamus Niger 30
Twice a day
- 28/ 12/15
Anger ++
Throws things and hits children and family members
Biting nails
Puffiness of lower eyelid – off and on
Stiffens limbs on waking- SQ-
Starting in sleep- SQ-
Breaking objects- SQ-
Obstinate- SQ-
Speech – slurred
Spasm of hands and legs –SQ-
Appetite- improved
Yellow discharge , thick from nose since a week
Snuffles
Sneezing occasional
Throat – elongated uvula
RX: 1. Kali bichromicum 200
Thrice a day/ 4 days
Followed by Hyoscyamus Niger 200 twice a day
- 19/03/2016
Anger>
Violence>
Swelling over lower eye lid – SQ-
Speech- slurred
Spasm of hands and legs on waking or during fear – SQ-
Restlessness- >
Since 10 days
Barking cough +
Cough < night
< waking on
Paroxysmal cough
Coryza – thick yellow
Appetite- diminished
RX:
Spongia 200
Thrice a day/ 5 days
Followed by
Hyoscyamus Niger 200 twice a day
- 12/04/2016
Cough- 0-
Cold-0-
Anger>
Restlessness>
Biting>
Speech improved slightly
Spasm of hands and legs on waking or during fear >
Swelling over lower eye lid- persists
RX:
Hyoscyamus Niger 200 thrice a day
- 12/07/2016
Hits other children in school (not at home)
Studying well
Swelling over lower eyelid >
Restlessness>
Speech – improved
Spasm of hands and legs >
Appetite – improved
Anger- >
RX:
Hyoscyamus Niger 200 thrice a day
- 28/08/2016
Anger >
Biting and hitting -0-
Restlessness >>
Studies well, performs well
Speech – improved further
Spasm of hands and legs on waking or during fear >>
Eye- swelling over lower eye lid >>
Appetite- good
RX Hyoscyamus Niger 200 thrice a day