Name: XYZ -Female – Age 25 years
Married 1 ½ yrs. Female
Education: BSc, D. Pharmacy
Spouse: ABC, 30 Yrs, BHMS
Father, Mother, 3 Sisters
|NO.||Location||Sensation & Pathology||Medications||Other|
|1||BRAIN & NS
D- 23 Yrs
Start at 2 years of age
1st Episode as Febrile convulsion
Severe seizure was 1-2 times in a year, these symptoms are suppressed 2 Yrs
Other symptoms From aura to Post convulsive phase persists, now frequency is Every 15 days, last for 2- 3 days.
Right side more
|Aura: Disagreeable smell, Heat sensation3+
Heat steams at Head & abdomen extend to whole body,
Heart rate and RR ↑
During Convulsion: She stops her activity → Blackouts or unconsciousness
While working suddenly stops and remains like statue.
Unrolling of eyes, Incontinence of urine,
Clenching of teeth, Biting lips 2+, then motion of Hands
Urging to stool
Post convulsion: Headache3+, vertigo3+, Sleepiness3+
| Allopathic medicine
Gardenal, Eptoin, Carbamazepine, Oxycarbazepine, Levigress, Frisium,
Took regularly Anti convulsive medication
Time to time
1 ½ years Along with Allopathic medicine Homeopathic medicine from Different Homeopath taken but Frequency and Episode
< Alone while2+
< Tries to Wake her3+
> Wraps or Covering3+
Fear, Palpitation & Sighing 3+
PATIENT AS A PERSON
- Appearance: fair complexion, average build
- Perspiration: Upper lip
- Digestion: Chicken → Acidity (heartburn), Hunger <2+, Craving chicken, meat, Aversion Curd 3+
- Elimination: Stool, hard
- Menstrual function: Menses regular, last for 5 days, LMP-27/10/2017
- Sun2+ <, Fan: S & R- Full, W- Low, Covering: S- NR, W- Blanket up to neck, Bath: Tepid- S & R, Luke warm-S.
- Past history: Meningitis, Granuloma Mammary gland took AKT for 8 months
- Family history: Epilepsy to sister
- Physical examination: T- Afeb, P- 80/min, RR- 18/min, BP- 110/80, conjunctiva-pink, Tongue- Trembling, RS- NAD, CVS- NAD, CNS- NAD
LIFE SPACE INVESTIGATION
Her maiden family includes father, mother and 3 sisters. At the age of 2 -3 years, during a fever, convulsions develop. Her elder sister has severe epilepsy so the family was aware of this illness. Hence, they prepare the whole family for the social consequences of such illness. They took extra care of patient and started early antiepileptic medicine. In her younger days, patient was not aware of her sickness. She enjoyed a lot tension-free life but soon she has episodes while playing games and gets memory deficits. She noticed her behavior was different from her peer group. Her family was afraid the social stigma would potentially hinder marriage. Her family warns her not to disclose her sickness or any trace of her odd behavior to anyone.
She was fair, chubby and lovable, wanted to play, enjoy trips and socialize, but loses her confidence day by day due to adaptive avoidance social patterns. In order to hide sickness, she gradually reduced her socialization and nervousness and irritability increased. Dullness and sleepiness overpower her health with increasing antiepileptic medicine which blocks her scholastic ability and teenage vigor. She tried to stop those antiepileptic medicines but exacerbation occurred and life with medicine was inevitable.
She is fair complexioned and well built. She is a science graduate and married to a medical doctor (BHMS). Her in-laws family are unaware of her illness and still don’t know. Her husband came to know about her illness but he does not communicate it to his family. She is in constant fear that in-laws and relatives will observe her sickness. They tried homeopathic treatment from reputed homeopathic consultants but without result. They subsequently consulted me. Now she conceived a child, and her fear and anxiety increased.
FAMILY HISTORY: EPILEPSY
Past History: Febrile Convulsion, Tuberculosis Mammary Gland (Tubercular Miasm)
Emotional Type: Timidity, Irritability
Physical Type: Chilly Patient
Diathesis: Tubercular, Predisposition To Convulsion
Functional Phase: Epilepsy
Aggravations in General: Contradiction, Chicken, Hunger, Sun
Sensations & Complaints in General: Epileptic Convulsions
Brain and Ns, Convulsion
Aura– Heat sensation starts at head and abdomen and extend to whole body
Post Ictal– Headache, Vertigo, Sleepiness
Concomitants: Irritability ↑, Socialization ↓, Timidity
PROGRESS RECORD: CHANGES EXPECTED WITH RX
- Timidity / Socialization / Irritability
- Aura Epileptic: Smell & Heat flashes
- Blackouts / Unconscious spells
- Biting of lips
- Post seizure: Headache / Vertigo
- Seizure frequency / Month
- Recovery period
- Drowsiness period
|Date||Symptoms Changes I & E||Prescription|
|Gels 200 7PHS
Rii Pills BD For 7 Days
Medicine for 2 month.
|15/02/2018||Lips bite||Gelsemium 1M 3PHS
Rii Pills BD
|25/02/2018||Acute||Gelsemium 1M 4 Hrly For 2 Days|
|27/02/2018||Acute not much improvement,
Glonoine 200 for Acute episode given which stopped convulsions.
Recurrent convulsion episode was reduced but not completely stopped by Gelsemium hence considering Tubercular as Dominant Miasmatic Predisposition Tuberculinum an Intercurrent medicine given.
|Glonoine 200 4Hrly for 3 days
Tub 1M 1PHS
Gelsemium 1M 6PHS
Rii Pills BD for 7 Days
|20/03/2018||Tub 1M 1PHS
Gelsemium 1M 6PHS
Rii Pills BD for 7 Days
|19/04/2018||Ct all for 1 month|
|19/05/2018||Ct all for 1 month|
|19/06/2018||Ct all for 1 month|
|20/07/2018||Ct all for 1 month|
|25/08/2018||She delivers baby safely. No Convulsion during and after pregnancy, baby is healthy.||Ct all for 1 month|
DISCUSSION: Under purely allopathic medication even after changing many medicines and with combinations and increasing doses of medicine, convulsion episodes and frequency was not controlled. It was every 15 days. Only some gross manifestation like Incontinence urine, clenching teeth, biting lips and convulsive movements were suppressed. Her anxious disposition increased.
After administration of Gelsemium she shows sign of improvements. Her anxiety improves a lot. Physical sensory and motor disturbances ceased. She remains uneventful during her pregnancy period. Mother and baby are healthy. Overall, no aura, convulsion and post convulsion headache or vertigo remain. She becomes active and sleepiness and dullness are gone. Sometimes a slight dizziness comes for fraction of second and leaves. Still she is under my care. Her homeopathic and allopathic medications continue.
Gelsemium alone improved her a lot, hence she did not receive Tuberculinum initially. The patient was better under Gelsemium 200 nightly doses for 2 months. Sensory and motor manifestation was reduced but frequency was not significantly changed and the acute episode intensified once. Here Glonoine relieved her. I identified her acute episodes as evidence of strong genetic predisposition. Gelsemium does not seem to touch the genetic predisposition, hence I later gave the deep acting Tuberculinum. After adding Tuberculinum 1M weekly one dose, recurrence of episodes stops and overall mental and physical wellbeing were manifest.