A Case of Panayiotopoulous and Tourette Syndrome Treated with Classical Homeopathy

The Case

A girl was first brought to me when she was 4 years and 4 months old.  She had just had an episode of convulsion. She had been previously diagnosed by a neurologist as having the Panayiotopoulos syndrome – early–onset benign partial (autonomic) epilepsy syndrome.

The mother reported that since one year the child had become more reserved at kindergarten, sometimes isolated herself from the other children and played more by herself(2). The caregivers and the nursery-teacher had noticed that she sat more quietly at the table; she would push the food away(2), get angry and cry at the slightest remark (2). She sighed a lot(2). Usually a happy and communicative child, the other children also liked her very much. So such a sudden change of mood seemed strange considering there was no other problems at school or home.Her parents also had a happy relationship.

On further questioning, the mother revealed that this very condition appeared after weaning her off breast feeding at the age of 3. The mother, in order to make the child averse to breast feeding had colored her breasts with a black marker and upon the child’s return from kindergarten, she uncovered her breasts suddenly and said that there was no more milk inside them.

The child got very frightened and “shuddered” for the first time at the sight.  This was followed by a period of no acute episodes accompanied by fever.

She now became moody, having moments of sadness and sighing (2), sometimes just gazing (1). She would ask her mother to tell her the same sad stories, over and over again: “Haensel and Graetel”, “The little match girl”. She began using black color more frequently. She started while falling asleep (1). She had perspiration on her face (1) and she would refuse to eat fruit (3) and eggs (2).

Two weeks before the first consultation, apparently out of the blue, the girl vomited and had eructations followed by a second vomiting episode,waking her up from her afternoon nap. She was conscious, pale, told her mother that she was feeling sick and then she threw up again (1). Immediately after, her head turned to one side (the mother does not remember the exact side), developed twitches on her face (2 )and the gaze appeared (1). Afterwards, she became non-responsive and confused and fell into a deep sleep. All this lasted for about 10 minutes but due to panic the parents could not describe exactly what had happened.

The girl was taken to the emergency room and later to the neurology ward where an EEG was performed. The diagnosis made was Benign Childhood Autonomic Epilepsy (Panayiotopoulos Syndrome). No anti – epileptic medication was given as this was the first episode.

Personal medical history

No neurological disorders could be found in the family history. However, the mother is an emotional person, full of fears, who had experienced many fainting episodes during her childhood – episodes presumably Long QT syndrome. She had been treated with Propranolol 20 mg/day, for many years and even during pregnancy and breastfeeding.

Her uterus was malformed and she underwent the monthly ultrasound examination during pregnancy. At 7 months of pregnancy, she experienced a strong fright and had to be delivered via C-section on 10.10.2012.

During infancy the child cried a lot, wanting to be constantly held by the mother who had to give all her attention to the child. It was difficult, as the child did not sleep much during the day.

All the mandatory vaccinations had been administered (Pentaxim, Infanrix) until the child was 1 year of age; the vaccinations were followed by fever (38^o C) and infantile eczema (face, cervical region) – no treatment was given for the eczema. The child started nursery at 11 months and until the age of 3 experienced many acute episodes (especially tonsillitis but also chickenpox, and hand foot and mouth disease). Some were accompanied by high fever episodes 39-40 degrees C.She was given homeopathic treatment but the mother does not remember the remedies administered. No antibiotics, antipyretics or other allopathic medication had been administered during that time.

Family history

There was no information regarding the father’s family history.

As for the mother’s family history, apart from the ones mentioned above: the maternal grandfather died at the age of 52 years due to pancreatic cancer. The remaining grandparents had lived long and had enjoyed good health.

Other symptoms: capricious appetite (2); egg aversion (1); fear of the dark(1)

The case was repertorised with Vithoulkas Compass

Prescription on 25/09/2016: Ignatia amara 1M one dose

Remedy choice: Ignatia amara was chosen due to the combination of keynotes, the totality and essence of the case. Also, a reason for choosing Ignatia amara was the fact that it is a remedy administered for sudden effects on emotions (just as Opium). The 1M potency was chosen because of a clear remedy pattern, and because these problems are of emotional nature and the pathology was located at the level of the nervous system.

Follow Up 1 (via phone) after one month

The girl was much better mentally emotionally and had no more sadness.Normal behavior, no complaint. No initial aggravation.

Follow Up 2:

Unfortunately, the mother only returned with the child one year laterwhen the child was already displaying many tics. She reported very mild acutes without fever during past year.The complaint started as a sensation in her throat, like having mucus (1), which she tried to eliminate (1). Soon after this, strange movements of the head and facial grimaces appeared (2). She felt the need for stretching her limbs (1) and experienced a dry, nervous cough (1). All these symptoms were present only while being at home and could never be observed when the girl was at the kindergarten. The kindergarten personnel could not see anything different with the little girl. Meanwhile, the child had become “the kindergarten-teacher’s favorite”, being much loved by her classmates, as she wanted to please all of them, not wanting to annoy anyone. She liked to get noticed, be praised, talk to the adults and get the maximum attention.

The clinical manifestations also appeared while in kindergarten, when a new girl came to her class and succeeded to “dethrone” her as the kindergarten-teacher’s favorite. She felt neglected (1).

She could not stand being left aside. However, she would never take the first step, waiting to be called to play with the other children (even when the other children were visiting her, at home).

She would always get very upset when such things happened but upon getting noticed, she would quickly return to her previous good mood and become happy once again. She would succeed in getting the most attention, afterwards becoming tired and longing for more sleep.

After the neurological exam she was diagnosed with the Tourette syndrome.

The symptoms were repertorised on Vithoulkas Compass again:

Prescription on 18/10/2017: Palladium 1M – administered as a single dose caused the complete remission of the tics, shortly after its administration. The remedy was chosen due to the totality of the symptoms, the essence, the keynotes and the pathology.No aggravation has been noticed.

Follow Up 3

On 16/01/2018, the mother returned with the child, because the girl experienced a relapse accompanied by almost the same clinical symptoms as the previous year – only slighter in intensity. During the whole past year, the girl had experienced two acute episodes (first one, weeks after Palladium) with relatively high fever (a good sign), but these acute episodes had been treated with allopathy, for fear the convulsions would appear. The neurologist recommended that the fever episodes be avoided!

This time, the girl mentioned feeling neglected by the new kindergarten-teacher: “she does not hear me, she does not mind my presence”.

Constant craving for compliments, encouragements. The need to be complimented is exaggerated. She gets angry easily when facing critique.

Just like the previous year, the first sign to appear was the sensation of having something in her throat and her need of clearing her throat or coughing.

And just like the last time, the tics appeared more frequently when she did not know she was being watched (her mother recorded her behavior, while watching TV or playing).

Prescription: This time, Palladium 10M, after aggravation, brought an almost complete remission of the tics, in less than a week.

The last follow up before sending in this report was on 24/10/2018. The girl had no tics and is generally well too.

Discussion

The defense mechanism of the child had been quite strong from birth. The frequent acute episodes accompanied by high fever – which did not call for a special intervention – she had experienced between the ages of 11 months up to 3 years of age, placing her on the health Level 4 (Group B).  The vaccines administered during her first year of life were followed by fever episodes.The baby’s dermatitis had not been suppressed with cortisone and she received no antibiotics. But the “brutal” weaning which led to the sudden fear, caused an abrupt descent to the health level 7, making the child experience no acutes until last year (for 2.5years). Furthermore, the girl has an emotional frailty inherited from her mother and it is possible that she has also inherited other predispositions from her father’s side of the family – predispositions unknown to us at the moment – that could complicate the whole situation. It is rather unusual that such a factor, as the one described above (the way the mother decided to wean her), could cause such a strong effect on the child’s body. There might have been other factors which have contributed to the undermining of the defense mechanism – the Propanolol treatment, the vaccinations, the monthly ultrasounds.

Although the acute episodes, which have appeared after the Palladium treatment, are a good sign, if the mother continues to treat the acute pathology of her child, with allopathic drugs, the prognosis could be a rather reserved one, as a relapse could appear on the level of the nervous system or even on a more profound level – the mental-emotional one. In this case, the mother’s attitude could represent an obstacle on the path of healing and she would have to choose the therapeutic path to be followed.

Homeopathic laws as taught to us by Prof Vithoulkas are appreciated in every case and following them is a sure way of scientifically dealing with disease, health and cure

Conclusions

Homeopathy may be of service in neurological conditions such as the Panayiotopoulos Syndrome and Tourette Syndrome provided we follow the rules of homeopathy strictly.