Patient was a female aged 11 years. Prior to the first appointment I was informed by the mother that the girl suffered from tics and jerks, involuntary movements diagnosed as chorea. Over the years things had gotten worse and now she found it very tiring. She had been to a lot of doctors, and nothing had been done for the condition so far. She was a very anxious young girl.
Initial Consultation: Immediate observation – quiet child, obvious fatigue and involuntary movements are multiple and obvious. Blinking +++. Unusual amount of anxiety noted for a young child.
C/o – Jerking of arm and nodding of head – involuntary. (observed)
Flexes her arm – at the wrist > flexing of wrist. (observed)
While nodding of head occurs occasionally – it’s not controlled.
Other movements – hits her chin, rubs her chest
Blinking +++ – (observed) – This has been since she was 3 years of age. This was the first symptom.
Eyes – allergies – bumps on eyelids. Feels there is something in her eyes. Left ++, Right +. Doctors have said she has a blocked tear duct in the left eye. Eyes feel tired. Takes anti allergens daily. Rubbing of eyes ++ does not relieve. The symptoms frustrate her a lot. Every morning she wakes up with it and it does not stop unless she sleeps. No particular time aggravation noted.
Difficulty swallowing – H/o enlarged tonsils and repeat tonsillitis as a child. Was treated with antibiotics and other medication.
Sore throat last week – it’s a common thing – she won’t take antibiotics now. Bad breath is a common occurrence if her tonsils are infected.
Last fever was 2 months ago – not sure how high. Did not go to school for two days. Last noted high fever was 39 degrees some time last year.
Pain in stomach – before or after dinner. Feels uncomfortable. Anxiety.
Sleep – needs lots of sleep – 8:30 pm to 7:00 am. Pushes her feet out of the covers. Sleeps on her abdomen.
Very active child – does jazz, acrobatics, swimming and art outside school. Enjoys it a lot. Has to be on the top even academically.
Perfectionist – wants things done in a particular order. Mother is very organised as well.
Anxiety when things are not in order. Has to perform in her way/must do things her way. Gets upset or anxious otherwise. Nodding increases.
Fears spiders and thunderstorms. Worries before going to bed – worries about her brother, fear of fire, checks if the house has been locked, especially because dad works away for a period of time.
Can’t wear things around her neck.
Desires Salt, Milk, Honey
Aversion – tomatoes – they are not easy to swallow
Stools – Normal Urine – NAD
PHOSPHORUS 10 m SINGLE DOSE
|DATE||SYMPTOMS||PRESCRIPTION and rationale|
|11/07/19||· Was not well in the first week after remedy was given. Sore throats and headaches- Head – pain left side, occipital region – sore head – like I had a knock on the head
· Except for blinking no other tics/jerks are noticed.
· Eyes are much better – no anti allergens taken since the last consult; Difficulty taking a full breath, occasional chest pains
· Fatigue worse in the evenings – has been tired and cranky.
· Patient is more expressive, giving her own complaints.
· Sometimes I want to throw something at my brother. Don’t like it when dad loses his temper. (Mother says – wants things her way – very sensitive); Anxiety about health <evenings – talks to mum about it; Fear and very sensitive to something she has heard or seen; Sensitive to odours, or loud noises, or anything out of place.
· Loves being held – wants hugs and cuddles. Same with friends. Loves company.
no sudden movements observed till the end of the consult.
SAC LAC – Single dose.
[Placebo was prescribed as the remedy had shown its effect, and amelioration was noticed in her complaints and in general energy.]
|27/08/19||· Observation: Chorea: nodding is worse – a couple of sudden movements observed with the wrist, her sudden movements are back. The nodding is almost continuous; Feels uncomfortable – must move or flex her wrist.
· Eyes are better – they do not itch as much, the eruptions on the eye lids and around are better.
· Tonsil stones are coming up daily. Tonsils are still enlarged; sensitive teeth; Generally exhausted
· Fear something will happen – the house will be broken into.
· Incident at school – sympathetic – worries about her friend.
|Rx. Phosphorus 10M –single dose
[Her complaints had aggravated, and her anxiety increased. The interrogation regarding possible antidotes were unclear, hence remedy was repeated.]
|04/11/19||· Patient has developed an acute 1 week after the last consultation
· Had no fevers since the last attack of tonsillitis – now high fever – 40.2 degrees – since yesterday.
· No perspiration; Face red cheeks/hot; Feet – cool
· Tonsillitis – red, inflamed and bilaterally enlarged.
· Pain on swallowing esp. solids – extending to ear.
· Cough with mucus in chest. <sleep; Cracked lips. Not drinking.
· No odour from the mouth. Dull and lethargic appearance.
|BELLADONNA 200C – One dose
|25/11/19||· No fever since that one incident. Lasted for around two days.
· Observation: No sudden movements or tics noted. No nodding or blinking. Eyes appear normal.
· Nodding remains the same (according to mother); Sensitivity is the same – she jerks or nods when distressed.
· Tonsils seem to have gone down in size. Eyes – no complaints at all.
· Complains of sensitive teeth again.
· Tonsil stones continue to come out on a regular basis.
· Has not been asking as many questions about her health and is not as particular with her things. More relaxed.
· Overall anxiety has increased – needs mother again before she sleeps.
· Sleep makes her feel much better.
Phosphorus 10M – single dose.
[ The prescription was repeated as her anxiety had increased considerably. She has visible fear and needed her mother by her all the time. Typically, in a chronic case, if a strong acute appears, there is a relapse in the chronic after the acute disease. At such times, the chronic remedy needs to be repeated]
|01/02/2020||· Observation – She looks very tired, not as expressive, lethargic. No sudden movements or nodding of head observed.
· The neck now feels like it needs to move backwards and nodding happens in the evenings sometimes. (Mother mentions she gets distressed when this happens < anxiety)
· Fatigue of muscles around neck and head.
· Tired – end of day
· Large tonsil stones come out almost regularly. The tonsils do not appear swollen and enlarged anymore.
· Anxious because school is due to start. The family has been taking it easy for the last weeks – resting and relaxing.
· Mother says she is not as particular about her things and how she goes about her activities.
· Needs to sleep – refreshing.
· She also says that in spite of taking things easy the anxiety in the evenings is getting stronger.
· Extremely sensitive – worrying about the wild fires and how it has affected animals and people. Still worried that something bad will happen.
· Has been for climbing activities – ‘I am not scared but careful.’
Phosphorus 10M-Single dose
[The patient had jerking of the head backwards. Anxiety has increased, and is sympathetic. Hence the remedy was repeated.]
Fig. 2 Repertorisation during acute