Clinical Cases

Nocturnal Enuresis in a Girl of 10

The authors share a case of nocturnal enuresis in a girl of 10. The girl’s sympathetic nature, aversion to quarrels and the absence of pathology led to the simillimum.

A girl of 10 visited our A. M. Shaikh Homoeopathic Hospital on 22/07/2019 with her father who described her case in detail with the presenting complaint of bed wetting the last 5 years.

History of presenting complaint
Patient came with the complaint of bed wetting at night and daytime as well; there is no single dry night since the last 5 years. At times she passes urine 2-3 times a night and once during her day/evening sleep.

No H/O Night terrors or Nightmare.

Treatment history:
Has consulted an allopathic paediatrician and was on treatment for 3 years with no desirable improvement.

Past history: No H/O any major illness or any remarkable events occurred since birth.

Family history: Nothing significant. No family history of enuresis.

Milestones:
Neck holding – 4th month
Monosyllable speech – 7th month
Crawling – 9th month.
Sitting without support by 10th month.
Walking without support – 14th month.
Normal speech with meaningful words – after18 months.

Personal History: 
Diet: Vegetarian
Appetite: Not adequate, hardly eats a roti at times.
Thirst: 1 – 1.5 litres / day,
Micturition: D/N : 3-4/2-3,
Stools: Once/day, Regular, Soft.
Desires: Spicy food.

Life Space Investigation:

  • Birth history: Full term normal hospital delivery. Mother had absolutely healthy pregnancy throughout the term. Mother was not a known case of hypertension, diabetes mellitus, hypothyroidism. No H/O any insult (injury) at birth.
  • Post delivery – till date: Patient was born and brought up in Kadoli, Belagavi. No remarkable events since birth.
  • She is good in studies, mingles with people easily. She speaks freely without fear in front of people and has won in almost all the school debates she has participated in, yet she is timid. She cannot tolerate the pain when other people are quarrelling (reaction sympathetic). She is so sensitive that she cannot even tolerate the fighting in movies. If she sees any beggar on the road she offers to help.

General Physical Examination:

Patient is moderately built and moderately nourished. No pallor, cyanosis, icterus, clubbing, oedema or lymphadenopathy, temperature: 98.6º F. (Afebrile),  Thermals : Hot,  Height :129cms,  Weight :26kgs, Birth Weight : 2.75kgs,  Pulse rate :84 bpm, Respiratory cycle : 18cpm.

Clinical diagnosis: Primary enuresis

Totality of symptoms:

  • Bedwetting at night and daytime.
  • Desires spicy food.
  • She cannot tolerate when other people are quarrelling (reaction) sympathetic).
  • Hot patient.

Analysis of symptoms:

Common symptoms Uncommon symptoms
Bed wetting. She cannot tolerate when other people are quarrelling.
Timid but speaks in public.
Desires spicy food

 Prescription: Causticum 200 HS  1 dose

Basis of prescription: This case was analyzed without repertorization, as we found the substantial / peculiar symptom (sensitive to emotional disturbances) for prescription while case taking.

Follow ups: (written as it is expressed by father)

29/07/2019
Father said patient has passed urine only twice during her sleep since last week.
Complaints are better by 50%.
Prescribed  Placebo BD for 15 days.

19/08/2019
Patient has passed urine during day sleep only once the last 10 days.
No bedwetting at night last 10 days.
Appetite has improved. Her father said she asks for food now.
Patient is better by 75%.
BD for 15 days.

03/09/2019
Bedwetting only once at day sleep and no bedwetting at night the last month.
Feeling generally better.
No new complaints
Placebo  BD for 15 day.

Follow up at 12/2019:  No further symptoms.

Conclusion: Enuresis can be successfully treated with detailed homoeopathic case taking with individualised homoeopathic medicine along with encouragement. A positive attitude and motivation are important components of treatment. Punishment and criticism have no role to play.

References :

  1. O. P, BaggaArvind, Pual. V.K; Ghai essential paediatrics; 8th edition revised and enlarged; CBS Publications and distributors Pvt. Ltd.; NewDelhi; 2013, P-504.
  2. Kliegman, M. Robert, Stanton, F. Bonita. Geme, St. Schor; Nelson Textbook of  Paediatrics; 20th edition; ELSEVIER; Philadelphia; 2016;
  3. http://dx.doi.org/10.5350/Sleep.Hypn.2019.21.0168. Sleep and hypnosis : a Journal of Clinical Neurosciences and Physiopathology.

Case prepared by Dr Shashank H S, Dept of Paediatrics, PG Part 1A M Shaikh Homoeopathic Medical College , PG Research Centre &  Hospital, Belagavi.

Under the guidance of:
Dr Nahida M Mulla. M.D (HOM); MACH
Prof. and HOD Paediatrics, A M Shaikh Homoeopathic Medical College , PG Research Centre &  Hospital, Belagavi.

About the author

Nahida Mulla

Nahida Mulla

DR. NAHIDA M. MULLA M.D. is currently Principal, HOD repertory & PG Guide, HOD Pediatrics at A M.Shaikh Homoeopathic Medical College, Belgaum. Dr. Mulla is also a member of Karnataka State Wakf for Women"™s Development and a resource person for Continuing Medical Education. She was also a Resource person for the Re-orientation Programme for Teachers (Physiology & Biochemistry) at Government Homoeopathic Medical College Bangalore. Dr. Mulla has presented numerous scientific papers and contributes to many websites.

About the author

Shashank H S

Dr Shashank H S, Dept of Paediatrics, PG Part 1
A M Shaikh Homoeopathic Medical College, PG Research Centre & Hospital, Belagavi.

Leave a Comment