Mild Cognitive Impairment in a Man of 82

This is a case of mild cognitive impairment in a male patient of 82 years, that I saw on 5th February 2019. On 4th February I received a call from the patient’s daughter that her father had been talking incoherently and was not looking in complete control of himself. He was having involuntary urination and defecation since that morning and was reluctant to even get up from bed, thinking that he might fall down. The daughter remarked that her father drove his car to a place 40km away from his home a day prior to this complaint, without having any purpose in mind. He was not even carrying his license and phone with him and stopped at a PCO booth to make a phone call to his wife, asking her to come and drive hm back home. This incident made him feel extremely ashamed of himself and within hours he developed incontinence. He was advised adult diapers which further made him feel embarrassed.

The next day when the patient entered the clinic he was held by two attendants as he was unable to walk and was falling over to one side while attempting to walk. The daughter exclaimed that her father had been very stubborn the whole night and was talking in an absurd way. He feared being poisoned by his family members and was constantly saying that his family was planning a conspiracy against him. He had been sleeping for most of the day. He was also behaving like a child. All this while the patient sat completely speechless in front of me and was constantly looking down on the floor. It seemed like he was almost on the verge of crying because of all the troubles the family members had to face because of him. He did not utter a single word in spite of the repeated questioning and was even avoiding eye contact.

See also

A Stroke in Progress

There were just two major indications that drew my attention in this case. The patient’s hands were in constant motion as he was looking down at the floor and he had a fear being poisoned. These were the only discoverable individualistic indications (the reaction of the patient in disease) I prescribed KALI BROM 30, in aqueous solution, a spoonful to be taken every 3 hours for the next 48 hours.

FOLLOW UP

By the next morning he was more alert. His gait became steady in a few days and he did not need an attendant to escort him when he came for the follow up. Incontinence was better from the second day and by the 6th day he no longer required a diaper and could feel the urge for stool and urine. He developed diarrhoea and slight swelling of the ankles which resolved on its own in two days. On 24th February his daughter called me and remarked that her father was back to his original self as he was shouting and looked much more confident than before. His appetite also improved and he felt hungry even after a meal (psoric change). The excessive sleepiness was also resolved.

The patient is at present doing his daily chores by himself and his level of alertness is much better as well.

COMMENTS

The excessive intake of potassium bromide induces a condition called Bromism, characterised by dullness and weakness. It includes neurological symptoms such as restlessness, irritability, ataxia, confusion, hallucinations, psychosis, stupor and coma. It mimics symptoms of senile dementia. Bromides cause depression of the nervous system and are used as hypnotics.

See also

A Case of Violent Abdominal Spasms

Kali Brom is a wonderful weapon in the hands of a homoeopathic physician to combat this syndrome (when indicated by the symptoms and given as per the law of similia similibus curentur). It has a direct action on the motor nervous system. It has the characteristic mental and physical weakness of the Kali group. The Kali Bromatum patient is active, restless and fidgety in the psoric phase. In sycosis, he becomes dull, slow and weak. In Syphilis it manifests as incordination at the mental and physical sphere with symptoms like weak memory, absent mindedness and incontinence. Kali Brom also covers ailments from embarrassment and loss of reputation. The embarrassment faced by this patient because of his behaviour triggered all his symptoms. In later stages of the disease Kali Brom becomes melancholic with utter indifference to daily chores. They cannot think of anything except their disease.

REFERENCES

KEYNOTES – H.C. ALLEN

Loss of sensibility, fauces, larynx, urethra, entire body; staggering, uncertain gait; feels as if legs were all over sidewalk.
…hands and fingers in constant motion; fidgety hands…
Loss of memory….absentminded
Depressed, low-spirited, anxious, “feel as if they would lose their minds”.
Inco-ordination of muscles
…slow, difficult speech

SYNOPTIC KEY OF THE MATERIA MEDICA- C.M. BOGER