Case Quizes Clinical Cases

Solution to last month’s Case of ‘Spino Cerebellar Ataxia’

Here’s the answer to last month’s chronic case quiz!

Last month (Sept 2012) Dr. Amarsinha Nikam posted a 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.

  • Excitement.

  • Talkative.

  • Cheerful.

  • Totality :

  • Excitement.

  • Lively

  • Jolly & Jesting.

  • Talkative.

  • Company desire.

  • Cheerful.

  • Selfishness.

  • < Consolation.

  • Rt. to Lt. complaints.

  • Aversion: Meat.

  • Slurred speech.

  • Bleeding gums.

  • Gait, staggering, tottering.

  • < Standing.

  • Thermal : Chilly.

  • Miasm : Syphilitic.

  • Remedy Selected : Belladonna 30

  • Response :

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.

  • D/D :

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

Best regards

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
5 MIND – FEAR – high places, of 117
6 MIND – HATRED – revengeful; hatred and 21
9 VERTIGO – FALL, tendency to 134
10 MOUTH – SPEECH – thick 41
11 EXTREMITIES – PAIN – Knees – morning 37
12 EXTREMITIES – PAIN – Knees – stitching pain 175

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.


Peter Dunseith


Dear (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.


Elaine Lewis


Jeanne Hadlock – Phosphorus

Rubrics – Synthesis

M-Mental exertion aversion Page 175

M-Alcoholism page 9

M-Loquacity 167

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-Diabetes 1924

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.

My rubrics:

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

Paloma Santiago


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.

Company desire

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!

Raj Arya


I used:

Extremities tottering gait

Mind mental exertion agg.

Mouth speech thick

Generals walking with eyes closed agg.

Nux vomica

Henry Stephenson


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

Louise Deacon


GENERALS – LOCOMOTOR ATAXIA (Homeopathy Treatment for Locomotor Ataxia)
MIND – FEAR – high places, of
MIND – ANXIETY – health; about – own health; one’s
MIND – DELUSIONS – insulted, he is
BACK – PAIN – extending to – Scapula
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



Plumbum Metallicum

(1) The nervous system is the special seat of action of Plumbum.
(2)Locomotor ataxia.
(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.


Dear Editor,

MlND – COMPANY – desire for

MlND – Dictatorial

MlND – Fastidious

MIND – FEAR – high places, of

MIND – HATRED – revengeful; hatred and


MlND – Loquacity





EXTREMITIES – PAIN – stitching – Knee

EXTREMITIES – PAIN – stitching – pressure – amel

EXTREMITIES – REST – agg, – Lower limbs


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.

Yours sincerely:

Dr. Halász Gabriella
(mobil: 06-30-9241-286)
Budapest, Hungary


1.cannot walk closing eyes on

2.fear of heights


4.desires sweets

5.untidiness affects

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

Maya Bhat


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)

Ashok Jay


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.

Salvador Rangel


I would like my remedy as :Argent-nit

The Intercurrent Remedy if needed: CARC.

Rubrics Selected

  1. Desire : Sweets, Fried food, Ghee, Ice Cream, Cold Drinks, Milk.
  2. Aversion : Non-veg (meat).
  3. fear of heights.
  4. Fear of Future.
  5. Mortification.
  6. Anxiety Future.
  7. Towards Chilly.
  8. Thirst.
  9. Osteoporosis

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.


Kaushik Banerjee.



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

Best regards,
Anurag Mittal


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.

About the author

Amarsinha Nikam

Dr. Amarsinha Nikam is a renowned homeopath who runs Aditya Homoeopathic Hospital and Healing Centre in Pune. He started his career as R.M.O. at Lokmanya Hospital Pune, Homoeopathy Division and subsequently practiced as the consultant Homoeopath for 14 years at various places such as Beed, Khopoli, Chakan, Kate – Pimple, Pimple – Gurav and Pimpri Gaon, Pune. Dr. Nikam teaches students to understand the depth of homeopathic treatment and differentiate it from other pathies. He instructs them in his method of practice, but also inspires them to innovate and explore.


  • Dear Dr Amarsinha Nikam
    I want to thank you for putting up your case of ‘Spino Cerebellar Ataxia’ after reading your case it helped me solve a case of MS whcih I have been treaing from 8/4/2010. Natrum Mur went well with the case in the initial stages and helped her 50% but there was the spasm of the upper limbs more on the right side which led me to Causticum but did not help her much. She was one year with this remedy but did not help her much. I would have never thought of Belladonna, as it is an acute remedy. After reading your case I was lead to review my patients case and see if Belladone works. On administering a dose of 30 C, within a week the patient could get up on her own where as she was bed ridden and had to be assited to raise her self from the bed. I am sure it will help her further in due time.
    Thanks again for givin your case online.
    Fondest Regards
    Julius Fernande

Leave a Comment