Clinical Cases

Sensory Neuropathy in a Woman of 55

neuropathy

Dr. Pooriya Jeste-Subhedar presents a case of sensory neuropathy in a woman of 55.

PRELIMINARY DATA

NAME                 XYZ

AGE/SEX            55/F

OCCUPATION    housewife

MARITAL STATUS   widowed

C/O

A middle aged lady, with no known co-morbidities, came to the clinic complaining of numbness of her right hand, its ring finger and middle finger extending to the tip, whenever she puts her hand in cold water. This complaint started one month earlier.

LOCATION SENSATION MODALITY CONCOMITTANT
Right hand and Middle, ring finger Numbness and tingling <cold water

<working/using the hand

>hot/warm water

 

ASSOCIATED  C/O

LOCATION SENSATION MODALITY CONCOMITTANT
Right shoulder Pain ,stiffness < Lifting grocery bags

 

PAST H/O             nothing specific

FAMILY H/O         nothing specific

PERSONAL H/O   

PHY GENERALS

App                         normal

Thirst                      normal

Craving                   nothing specific

Aversion                 nothing specific

Stool /Urine            Normal

Sleep                       sound

Dreams                    nothing specific

Habits/ Addiction-NA

Perspiration            normal

Thermals                towards chilly

SUMMER WINTER RAINY
FANNING ++
COVERING ++ ++ ++
BATHING Hot water Hot water Hot water
WOOLEN ++ ++

Menstrual H/O: –  menopause around 50 years of age

Obstetric H/O :-  1 female child, FTND

Clinical examination: Power/strength in both hands 5/5

Reflexes: motor/sensory: normal

Grip         : normal

DATE                                    COMPLAINTS Rx Dose
13/4/2016 Numbness of right hand and distal interphalyngeal joint of its middle finger extending to the tip.

<cold water < morning > movement

Rhus Tox 200 4 pills QID x 1 week
20/4/2016 Almost status quo, no change in complaints, 10% better Causticum 200 4 pills QID x 1 week
28/4/2016 Status quo , no change, says complaint is better by putting hands in warm water Hypericum 200 4 pills QID x 1week
4/5/2016 30-40% better, <working, cold water Hypericum 200 4 pills QID x 1week
11/5/2016 Status quo, 30-40% better, but now not aggravated by putting hands in cold water or working

Pain in right shoulder, can’t take her hand back

Hypericum 200 4 pills TDS x 1week
24/5/2016 Ring finger complaints reduced, middle finger numbness ++ 40-45% , Hypericum 200 4 pills BD x 1week
8/6/2016 She was almost 50% better, but c/o Right arm pain Hypericum 200 4 pills BD x 2 weeks
22/6/2016 Better. No fresh complaints. 70-80% better. Pain intermittently. Sac Lac 4 pills x BD x 2 weeks
3/7/2016 No fresh complaints. Sac Lac 4 pills x BD x 2 weeks
15/7/2016 Better. Now no pain even if she uses cold water. Sac Lac 4 pills x BD x 2 weeks
10/8/2016 For routine follow up. No fresh complaints. Sac Lac 4 pills x BD x 2 weeks
5/9/2016 For routine follow up. No fresh complaints. Sac Lac 4 pills x BD x 2 weeks

She was completely better, and did not have any complaints. I asked her to follow up only if required. She followed up.  Whenever she felt slight recurrence, it did not require anything other than placebo.

SELECTION OF RHUS TOX:

When the results weren’t satisfactory, I remembered our teachings ‘The remedy which comes through repertorisation is best described in Materia Medica and not in the repertory.’ After all, Repertory is an aid to the Materia Medica. When one finds the indicated medicine through repertorisation, one should not be satisfied with it but must read the effects of the medicine in the Materia Medica and compare it with other remedies.

SELECTION OF CAUSTICUM :

I went through the Boereicke’s materia Medica and found- “Causticum: extremities- unsteadiness of muscles of forearm and hand. Numbness; loss of sensation in hands, worse by cold, better by warmth. “

However, it didn’t give good results, hence I again went back to Boericke’s Materia Medica, and hypericum covered the following: ‘The great remedy for injuries to nerves, especially of fingers, toes and nails. Neuritis, tingling, burning and numbness. Pain in toes and fingers, especially tips. Crawling sensation in hands and feet.

Phatak’s Materia Medica quotes “An excellent remedy for the injury to parts rich in sentient nerves, especially fingers, toes, matrix of nails.”

Thus hypericum was chosen, and gave the above results!

About the author

Pooriya Jeste Subhedar

Dr. Pooriya Jeste Subhedar has completed her MD in Homoeopathy. She is a Homoeopathic consultant and Bach flower practitioner in Pune. She has done research in psychological problems of Geriatric patients and has dealt with cases of behavioral problems in children. Dr. Pooriya has also worked as medical officer at Sanjeevan Hospital, Pune. She has been part of an organization for eight years which holds a medical camp every year. She has worked as a consulting homoeopath at a charitable trust, Pune and also as a medical writer. twitter: @pooriyanatrum

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