One evening a 19 yr old obese [88kgs] woman along with her mother visited my clinic (23/9/14) for her following complaints:
- Convulsion attack since 9-10 yrs.
She had history of high fever in childhood in her schooldays. After that she developed convulsive attacks.
Presently scenario of attack:
During attacks her eyes turn right, neck turns right. Sometimes she falls down on the ground. The attacks last for 2-4 minutes. Consciousness is fully regained in 10 minutes after an attack. Weakness, body ache noted after attack.
- Acne since 4-5 years
Acne was mixed type, bloody pimples plus pustules spread all over face and they were painful.
Past history: H/O Jaundice, Chicken Pox in childhood. H/O Fracture of Left leg 2-3 yrs back.
About her family history: Father expired due to M.I. One attack prior five years ago. H/O D.M. to MGF
Desire: Not specific
Aversion: Not specific
Thirst: 6-8 glasses in Summer, 3-4 glasses in Winter.
Stool: 2 times/day
Perspiration: Scanty back, axilla
Menstrual History: Irregular since 6 months. Scanty flow. Cycle is 45 days.
Thermally: Towards hot
On observation: Obese Patient with marked dullness of mind. I have to repeat questions again and again.
Her mom was only member to earn a living. Patient’s history mostly given by her mother. Her mother says the daughter is always dull. She does not mix with anyone. She has decreased confidence level. After death of her father, she was weeping for a long time.
When I enquired about the situation, after her father’s death, the girl said “I was attached with my dad, but now I am used to it….”.
EEG : Abnormal awake EEG, So generalised epileptiform activity.
MRI : Prominence of the cerebellar folia & fourth ventricles. Suggestive of mild volume loss. No other significant abnormality .
She was on the following medications:
Oxetop 600mg bd
Lamitor 50 bd
If we see side effects of above drugs, we notice Dullness, Obesity , Acne, Amennorhoea. I was somewhat confused in doing the analysis, as patient had mixed symptoms, drug induced symptoms plus her own symptoms.
I tried to pick up the following rubrics as per totality.
- Mind: Dullness, understand; does not answer questions addressed to her, repetition, only after
- Face: eruption, Acne
3.Face: eruptions-acne-menses during
4.Generals: Convulsions menses before
5.Generals: Convulsions menses during
I read through Kali. Brom in detail.
Again I was confused, when I read Farrington’s sentence: ‘Kali. Brom does not cure epilepsy, it only suppresses’.
I referred to Redline Symptoms of MM by Lippe. Dr. Lippe has mentioned, menstrual ailments: before menses, during menses, epileptic spasms.
I was positive about Kali. Brom as it covered the totality. I prescribed Kali. Brom 200, which was the only potency available at my clinic.
Follow up after 1 month:
Menses appeared this month. Had epileptic attack before & during menses. Menstrual flow was increased. Flow for one week. Thick reddish clots. Had pain in lower abdomen during menses. Acne still as it was. Patient this time responded well to my questions: She was saying, “Doctor why I am suffering?” Like a Melancholic state.
I checked melancholic state in Kali. Brom and it was present.
I repeated Kali. Brom 200.
The few follow-ups were very hectic. She complained that her epilepsy attacks were not better and that she was troubled before and during menses. But after checking her generals, I was satisfied. Menses were regular, stool satisfactory and the main thing, she had become active and loquacious. Her weight reduced by 5-7 kgs.
I continued with the same prescription for months whenever needed.
After 8 months she settled completely. Her pre-menstrual epileptic attacks were present for just 3-4 seconds with less intensity. Her acne complaint improved.
Present Follow up: 23/2/16
As shown in Investigation; EEG, 20/2/16: Normal awake EEG
Patient was free from pre menstrual epileptic attacks for 6 months. Stopped all allopathic drugs. She doesn’t have any epileptic attacks. Also, now she is taking classes in dance and helping her mother financially. She is so talkative that now I am tired to listening to her! Her future plans: She wants to become a choreographer.
Conclusion: This case has taught me to stick to one prescription if it really works, to actually analyze the follow up by generals and not on particulars and to refer to different old books. It gives immense happiness when we really treat such chronic cases classically.
Nice case presentation
Can I ask you for a favor?