Ophthalmoplegic Migraine in a Man of 43

26 October 2022 – A male of 43 years presented with h/o distant double vision for two months associated with severe left sided headache and neck pain with pain on movement. He is a known case of hypertension for ten years and taking medication for the same. He went to an allopath and got the diagnosis of right lateral rectus palsy (esotropia), ophthalmoplegic migraine.

He said:  I have double vision. I see two images of one object. My vision is blurry when I see with my both eyes but it is clear when I close my one eye. Doctors diagnosed me having horizontal diplopia. I can see an object with its image besides it not above or below.

I am using prism glass as advised by ophthalmologist. I get frequent severe headache, which increases with noise. Have to turn off the lights during headache.  I do not know whether it is important for you or not but I observed that in my previous job I used to hold urine for long time and always had bad headache after that.

I am introverted but angry person. I do not reply anyone during anger. I try to calm down myself but I have revengeful thoughts for the same, however cannot harm anyone ever. I am fearful person. I cannot make major decisions without my mother or wife.

In office, I am not able to hold the assembly but somehow, I manage it. From my face, nobody can judge my internal state. I like to watch comedy movies. Family drama makes me sensitive. I cry if I see any sentimental scene in television or heard any bad news.

My wife does not like me weeping on such matters. I try to hide my feelings as don’t want to be embarrassed among people but my heart keeps on pumping loudly. I feel weak though eating well.

Past H/O-Nothing specific.

Family H/O- No major illness.

Analysis and evaluation-

During interview, I understood that this man is a simple, fearfull,withdrawn person who wants harmony and peace. Slight emotions shake him.

 Rubrics/ Repertorization

MIND – AILMENTS FROM – bad news

MIND – AILMENTS FROM – embarrassment

MIND – AILMENTS FROM – fright

MIND – ANTICIPATION – stage fright

MIND – WEEPING

MIND – SERVILE

HEAD – TEMPLES; complaints of

HEAD – HEAVINESS – urination amel.; profuse

HEAD – COMPLAINTS of head – accompanied by – Nape of neck – stiffness

VISION – DIPLOPIA – looking – sideways

VISION – DIPLOPIA – paralysis of muscles, from

VISION – DIPLOPIA – horizontal objects, of

VISION – DIPLOPIA

VISION – BLURRED

VISION – BLURRED – glasses adjusted; even after having

 Gelsemium, Natrum Mur, Sulphur, Sepia and Lycopodium came up.

 His mental symptoms favoured Natrum Mur but it did not cover the chief symptom about the vision. The Natrum patient is not submissive. Sulphur does not have blurry vision. Sepia is not submissive and it did not act on diplopia. Lycopodium did not support the physical complaints and embarrassment is not the aetiology of Lycopodium.

 Prescription –  Gelsemium 200 CH one dose prescribed on 26 October 2022.

 Comments on selection of remedy-

I never go with any remedy just because of its score on repertory chart. We need a remedy which should be the mirror image of the patient when we prefer a constitutional approach.  Gelsemium is not only for exam funk or for its famous 3D – Dullness, Dizziness and Drowsiness or for muscular complaints with trembling headache, paralytic weakness etc.

It is a coward patient with a torpor state.  Disturbance of any kind causes him to lose his concentration and consequently the position of comfort which he had achieved with so much effort.  This embarrasses him and makes him irritable, sometimes even delirious.

Because, it is difficult to regain this position, the patient does not want to be spoken to, avoids disturbances.  Ultimately he does not want to lose control which he has gained for himself. Even a little effort scares him.

Gelsemium people are basically gentle, sensitive and vulnerable. The opinion of others is important to them and they are therefore careful in how they approach people.Gelsemium can feel like a soldier on the frontlines, outwardly having to remain staunch but inwardly afraid of everything around them.

They expect peace and harmony and hence any bad news or sensitive scene makes them vulnerable. They feel better after crying.  There is a typical symptom in this case which attracted my attention towards Gelsemium – headache due to holding urine, it also covered the physical symptoms related to head and vision.

Why 200 CH?   200 CH is medium high potency, addresses the emotional and  physical plane equally. It is safe and recommended in sensitive patients.

Follow up after a month-

He said: I have 95% improvement in vision. It is almost clear. I can see an object without double image. Last time when I came here, I used to wear prism glasses, which I am not using now at all.  Without prism specs, I have fine vision.

It is like a miracle!  I have been advised surgery but thanks to you and homeopathy, my vision is back!  I do not have any more headaches. My blood pressure is normal. I first went for other medications. If I would have consulted you earlier, my vision might have cleared faster.

 Conclusion

The sixth nerve palsy treatment includes antibiotics, surgery, lumbar puncture, chemotherapy and other cancer treatments, prism therapy, injections and strabismus surgery.

Homeopathy treated it in a classical way in one month, by matching the core of the person with the core of the remedy.  My myth about Gelsemium covering only muscular weakness, 3 Ds-dizziness, drowsiness and dullness and examination funk got crushed.

This case taught me a key to successes by showing the meaning of Aph.258- Never be prejudiced toward any remedy. Thanks to Organon!

I shall continue his treatment to address the underlying cause of his hypertension.

Follow up after one month –

He said, “I have 95% improvement in vision. It is almost clear. I can see an object without double image. Last time when I came here, I used to wear prism glasses, which I am not using now at all.  Even without prism specs, I have fine vision. It is like a miracle!  I do not have any more headaches. My blood pressure is normal.

Follow up after three months-

Vision is clear, not using prism glasses.  Placebo given.

Follow up after six months-

He was stable. Blood pressure was consistently normal.   Placebo given.

Conclusion-

Sixth nerve palsy treatment includes antibiotics, surgery, lumbar puncture, chemotherapy and other cancer treatments, prism therapy, injections and strabismus surgery.  Homeopathy treated within a month,  in a classical way by matching the core of the person and core of remedy.

My myth about Gelsemium covering only muscular weakness, 3 D’s-dizziness, drowsiness and dullness and examination funk got crushed. This case taught me that the key to success is Organon and Materia Medica by proving the meaning of Aph.258- Never be prejudiced to any remedy.

I am not done here, shall continue his treatment to address the underlying cause of hypertension which is within normal range now but requires further treatment for cure.