Last month (Sept 2012) Dr. Amarsinha Nikam posted a case of ‘Spino Cerebellar Ataxia’. https://hpathy.com/case-quizes/case-of-spino-cerebellar-ataxia/
Many readers offered their solutions to this case, and we are reprinting their answers below . But first, here is Dr. Nikam’s solution to the case:
Solution to the case of ‘Spino Cerebral Ataxia’ :
My Observation :
Jolly & Jesting.
Rt. to Lt. complaints.
Gait, staggering, tottering.
Thermal : Chilly.
Miasm : Syphilitic.
Remedy Selected : Belladonna 30
After giving a single dose of Belladonna 30, he was admitted in my hospital for observation. Improvement started from the very first day.
On fifth day of his admission, when I was entering my hospital, I heard a very exciting “Hi” from my back. When I turned back, I saw him. His face and his gesture showed much excitement and surprise, and he was crying in joy that he could walk so much better than before. Previously he was walking in a zigzag manner and couldn’t cross the road, but he eagerly crossed the road in front of me to show his recovery. Also, he could close his eyes for more than two minutes without falling, which was an impossible task previously. Since then he could enjoy his bathing.
Gradually his BSL levels reduced and so his insulin level was reduced from 48 units/day to 30 units/day. The knee joint pain which was troubling him earlier, reduced gradually.
His speech was also improved.
Belladonna: This case fits Belladonna well. The patient’s nature of getting excited easily, being lively, talkative, cheerful, having a high temper, screaming and shouting when angry, was very well covered by Belladonna. As per the medicine, the patient shows strong Rt. sided affections (Appendisectomy when 9 yrs old, hepatitis) and also has complaints advancing from Rt. to Lt. (left scapular pain in1994).
Also, the neurological affections of spine and cerebellum causing ataxia, slurred speech, falling on closing the eyes, is well covered by Belladonna.
Nux Vomica: This medicine is very close to the case. Most of the signs and symptoms are well covered by it, such as the pathology, mind, generals, habits etc., but the talkativeness, jolly jesting nature, loquacity with lot of excitement and cheerfulness is more marked in Belladonna. Further, Nux Vomica shows advancement of complaints from left to right which is contradictory to that of the patient.
Lachesis: The foremost thing is that Lachesis has a lot of sexuality and malicious aspect in it, which the patient does not have. In addition, Lachesis is thermally hot and predominantly left sided with complaints advancing from left to right.
Readers’ solutions to the Case of Spino Cerebellar Ataxia
(See other responses below the original article)
This is a case of Spino Cerebellar Ataxia handled by the renowned Dr. Amarsinha Nikam. We published this in our Sept. 2012 issue and asked readers to find the rubrics to solve it.
Dear Dr A. Nikam,
thank you for your case.
My selection is Argentum nitricum
mind; FEAR; high places (47)
extremities; ATAXIA, locomotor (138)
generalities; PROGRESSIVE diseases (69)
generalities; GAIT reeling, staggering, tottering and wavering; closing eyes; agg. (17)
extremities; ATAXIA, locomotor; closing eyes agg. (5)
extremities; STANDING; impossible; closed eyes, with (1)
extremities; WALKING; impossible; closed eyes, with (10)
speech & voice; DIFFICULT speech (228)
back; PAIN; dorsal region; scapulae (473)
back; PAIN; dorsal region; scapulae; left (186)
stomach; THIRST; extreme (312)
clinical; DIABETES; mellitus (164)
mouth; HEMORRHAGE; gums (208)
skin; MOLES (19)
mouth; DRYNESS; tongue (248)
mouth; PALE; tongue (51)
respiration; SNORING; sleep, during (41)
perspiration; WARM (51)
perspiration; HOT (93)
perspiration; PROFUSE (387)
I will begin with Argentum nitricum(low LM often).
If it doesn’t work Duboisinum may be a possibility
Sebastiano Di Salvo, MD, Italy [email protected]
Here are the rubrics I used for my repertorisation of this case:
1 MIND – AMUSEMENT – desire for 50
2 MIND – COMPANY – desire for 188
3 MIND – CONSOLATION – agg. 55
4 MIND – DICTATORIAL 62
5 MIND – FEAR – high places, of 117
6 MIND – HATRED – revengeful; hatred and 21
7 MIND – LOQUACITY 217
8 VERTIGO – CLOSING THE EYES – agg. 51
9 VERTIGO – FALL, tendency to 134
10 MOUTH – SPEECH – thick 41
11 EXTREMITIES – PAIN – Knees – morning 37
12 EXTREMITIES – PAIN – Knees – stitching pain 175
13 EXTREMITIES – TOTTERING GAIT 172
14 PERSPIRATION – HOT 77
15 PERSPIRATION – PROFUSE 264
The remedies that came up for differentiation were Lachesis, Phosphorus and Belladonna.
I eliminate Bell because the symptoms have come on gradually and there is no acute intensity to the case. It is tempting to prescribe Lachesis because of the morning aggravation; the history of alcoholism; the anger and desire to take revenge on people who insult him.
In the end I decide to prescribe Phos, because of the patient’s intolerance for hunger; his desire for ice cream and cold drinks; his aversion to meat (non-veg); and his sociable nature.
I look forward to hearing the correct answer in the next issue of Hpathy.
Thanks for the interesting case.
Dear Hpathy.com (Homeopathy for Everyone),
Here is what I think regarding the Quiz case of ataxia. I wanted to go with Nux vomica! It seemed like he was an outgoing person, loved to socialize, loved to drink and smoke and enjoy parties; plus, we had the Nux v. short temper, especially about disorder! And he would shout at you if he was disobeyed!
But here’s what bothered me about Nux vomica, it didn’t cover a very characteristic symptom in the case, namely the vertigo on closing the eyes. And then the other thing that bothered me was that he was not sympathetic! Nux vomicas ARE sympathetic! He said he couldn’t be bothered helping people or giving needy people money. So that bothered me; plus, it’s not listed for fear of heights.
On the other hand, who is fastidious for order and cleanliness? Arsenicum! Who is very stingy about money and won’t help anybody? Arsenicum! I checked and Arsenicum covered the vertigo on closing the eyes and the fear of heights. It was also listed for the food and drink desires, the profuse perspiration, ataxia, knee pain better pressure, anger from contradiction…. So….. I think I will go with Arsenicum.
Jeanne Hadlock – Phosphorus
Rubrics – Synthesis
M-Mental exertion aversion Page 175
M-Alcoholism page 9
M- Anxiety, future 21
M-Anxiety, family 21
M-Fear heights 121
M- Weeping alone 248
M- Anger, trifles 13
Ex – incoordination, tottering, lower limbs 1488
Ex- Pain, stitching, knee joints 1578
Mouth- Speech, thick 689
Persp – Hot sweating 1834
Persp – Profuse 1836
Stomach-Thirst, small quantities 850
G-Company, amel 1909
G- slow manifestation 2044
G- worse morning 1886
G- rest agg. 2034
G- Tension worse and in general 2053
G- Pressure hard amel. 2025
Remedy – Phosphorus
Dear Dr Nikam,
I’d love to know your prescription because the case is very interesting. I’d choose Calc arsenicosa. I’d combine calc rubircs with ars rubrics because his mental complaints and personality are quite ars. he is chilly, thirsty, fastidious about tidiness and cleaniness, easy anger, easily offended and loves company. Because ars is not a deep acting remedy, we need a remedy that matches his physical complaints and his main miasm which is syphilitic. Calc seems to be the prescription for that.
Mind, Fear, High Places Of
Mind, Sensitive to Criticism
Mind, Cleanness, Mania For
Mind, Company, Desire For, Alone Agg. When
Mind, Anxiety, Future, About
Extremities, Pain, Knees, Stitching
Vertigo, Closing Eyes, Agg.
Mind, Alcoholim: Calc-Ars
Generals, Lack Of Vital Heat. Calc-Ars
RX: Calc arsenicosa
I selected Argentum Nitricum on rare symptom of can’t walk on closing eye which is very marked in patient, high places fear, <mental exertion.
Dr. Rupali Bhalerao
The remedies I selected were Carc and Phosphorus The rubrics I selected were:
Gener. : F/H – Diabetes, Paralysis ( Mixed Miasm).
person./H: Chickenpox, Jaundice, Appendix.
Desires: Ice – cream, cold drinks, sweets, milk, veg.
Friendly or affectionate.
Anxiety- family and future.
Despair recovery – so feel remorse and reproaching himself.
Sensitive – so easily irritate and anger
Fear of high places (4)
I thinks the best Remedy : 1st prescribe – Carcinocin 200c. ( due to hereditary syndrome)
2nd. prescription : Phosphorus ( his Similarity of symptoms )
Thanks a lot!
Extremities tottering gait
Mind mental exertion agg.
Mouth speech thick
Generals walking with eyes closed agg.
Rubrics Chosen from Synthesis repertory
Mind: Fear of high places
Mind desires company
Mind revengeful, hatred and
Extremities:Pain Stitching knees
Generals:Food sweets desire
Remedy: Argentum Nitricum
GENERALS – LOCOMOTOR ATAXIA
MIND – FEAR – high places, of
MIND – ANXIETY – health; about – own health; one’s
MIND – OFFENDED, easily
MIND – DELUSIONS – insulted, he is
SLEEP – UNREFRESHING – morning
PERSPIRATION – HOT
BACK – PAIN – extending to – Scapula
MOUTH – DISCOLORATION – Tongue – pale
MIND – SPEECH – distorted
I propose: Lycopodium C 200
Julia P. Lande homøopath & psychotherapist
I think the remedy is Phosphorus. Here are the rubrics I used:
Renata Polak – PHOSPHORUS
From DK Mishra
FEAR, HIGH PLACES OF : ARGENTUM NITRICUM
STAGGERING, UNSTEADY, WHEN WALKING WITH EYES CLOSED: ARGENTUM NITRICUM
(1) The nervous system is the special seat of action of Plumbum.
(3)Spinal cord sclerosed.
(4) Paralysis of lower extremities.
Dr. Sitaram Kewat
I would give him Alcoholus.
His symptoms started when he stopped drinking. Slurred Speech, Jovial , likes parties, tottering gait like an alcoholic.
Dear Sirs ,
I read the history of the patient who is suffering from Spino cerebellar Ataxia . He should be given Kali phos. 30 for at least two months . During this time he should control his diabetes, only by controlling his diet . For his Osteoporosis he should take Rhus Tox 200, once a week. Symphytum 200 once a week. After two months he should take Alpha Alpha mother tincture before every meal for a long time it will cure his diabetes.
MlND – COMPANY – desire for
MlND – Dictatorial
MlND – Fastidious
MIND – FEAR – high places, of
MIND – HATRED – revengeful; hatred and
MlND – lRRITAB|LITY
MlND – Loquacity
MIND – MENTAL EXERT|ON – agg.
MOUTH – DISCOLORATION – Tongue – pale
EXTREMITIES – PAIN – stitching – Knee
EXTREMITIES – PAIN – stitching – pressure – amel
EXTREMITIES – REST – agg, – Lower limbs
EXTREMITIES – TOTTERING gait
Phos / Ars / Causticum
Thank for the interesting case. My repertorisation I attached. The remedy I choose: Phosphorus C30 in daily repeated dose. I would to give a dietary advice to stop refined carbohydrate and milk.
Dr. Halász Gabriella
1.cannot walk closing eyes on
2.fear of heights
6.enjoyment with friends desires and misses a lot
7.anxiety future and health about
I feel the remedy to this case is Argentum Nitricum
remedy— sulphur 30c
Appetite : Good. Can’t tolerate hunger.
Desire : Sweets
Desire for ice-cold water.
Perspiration : Profuse, Hot sweating. Mole on nose & face
I like drawing.
I love being in parties and enjoying with my friends..(joy)
Varicella zoster virus is in the spinal cord, because he had the chicken pox as a child and this is latent in the spinal cord causing ataxia and several important symptoms, including many eye disorders.
I would like my remedy as :Argent-nit
The Intercurrent Remedy if needed: CARC.
- Desire : Sweets, Fried food, Ghee, Ice Cream, Cold Drinks, Milk.
- Aversion : Non-veg (meat).
- fear of heights.
- Fear of Future.
- Anxiety Future.
- Towards Chilly.
I then read Robin Murphy’s Materia Medica.Argent-Nit fits well for Ataxia and the Osteoporosis well covered by CARC. Carc has also the hereditary taint.
The answer to the case posted by Dr. Nikam on ‘Spino Cerebellar Ataxia’ shall be “Argentum Nitricum”, though few more cross questions would have further strengthened the remedy, here are my findings to choose it:
1) First and foremost is the want of balance in speech, walking etc. which makes Argentum Nitricum superior choice otherwise Arsenic Album resembles the case more closely.
2) < Mental exertion, < Tension,> Hard pressure
3) Desire : Sweets, Ice Cream, Cold Drinks.
4) Short tempered,
5) Talkative and enjoys company
6) Great fear of heights.
Other supporting symptoms:
Tearing or stitching pain not burning (Arsenicum)
Gradual onset of physical symptoms
Thermals: Towards Chilly
Dr Pardeep Singh – Phosphorus
Srinivas – Phosphorus is great remedy and also with strychinum X
Juan Gonzalo Soto Vélez. – Phos
Dr N.D Manikpuri – Phos
Vasiliki – Phosphorus
Hetal Vasa – Argentum nit.
Dr. Mapolin – Argentum Nit.
Carol McKenzie – Argen nit
Dr .Ilyas – Arsenicum can be remedy of choice, taking in account desire for company, avarice, chilliness, Phosphor or Arsenicum can be chosen, additional information necessary for differentiation.
Dr Aprajita – Arsenicum
Karen Punito Cleary – NUX vomica
Dr. Meha – Nux vomica
Syed Abid Ali Zaidi – Medorrhinum
Dr. Farhan – Mercury…
Melissa Crenshaw – Calc Carb.
Vidiasagar- hymosa, and rhus tox CM potency once in quarter, then go with ars.alb 30.
Andy – Nux Vomica or possibly Lycopodium
Visesh – Sul.30 -After one week, Argn. Nit. 30
Madeleine – Viburnum opulus
Shweta – Nat mur
Dr.Akram Butt – Argentum Nitricum -Then continue with Ailanthus 30, three doses daily
Sanjeev Singh – Alumina
Dr. Maina Mwea – Nux V 30C ,then give Argent N because of dominance of the mental
Nina Malek – Staphysagria, and some dose of Nux Vomica.
Dr Sanjay Padole – Agaricus 30
Gurdip Singh Chawla – Graphities and Nux Moschata
Shilpa – tarentula hispania and argentum nit as intercurrent
Adnan Hadeed – Nux vomica 200 at 4.00 pm and Arsenic Album 200 in the morning.
Swapnil Sankpal – Argentum nit or Alumina 30 repeated frequently with Medorrhinum 1M as intercurrent every 15 days.