Clinical Cases

Sudden Episodes of Drowsiness in a Boy of 8 Years.

Sudden Episodes of Drowsiness in a Boy of 8 Years.

Dr. Rupal Anandpara presents the case of an 8 year old boy with sudden episodes of drowsiness.

Homeopathy is practiced in many different ways throughout the world.  I emphasize thorough case taking and integrating medical knowledge to come to a diagnosis both medically and homoeopathically. I then choose the most similar remedy, administering it at intervals based on knowledge of Organon. The approach will be different for individual cases. As the history taking progresses, I determine which path to follow, .whether to start with PQRS, or give importance to causative factors or mentals or miasms.

CASE

First consultation of this case was on Skype as the patient was not able to get up and come to the clinic.

CC– Sudden episodes of Dizziness/drowsiness with yawning. Patient wants to lie down. Can’t sit up even to have lunch or dinner. Sleeps for 30-60 minutes , then awakens. Strong need to lie down all the time. If forced to walk or sit up, he would cry, saying he can’t and wants to lie down.  Each episode would last for 2-3 weeks.

The complaint was first experienced when he was age four and in kindergarten. It occurred again at age six. Each time it took 15-17 days to recover.  This time he had the same complaint two months back.  His mother now thought of homeopathy and went to a homeopath.

He was given Apis mel 30. He recovered that time, but the drowsiness came back again after 2 months. This time Apis didn’t work.  The homeopath gave Gelsemium 30. No improvement.  At this point the case came to me.

He and his mother were having their lunch in a restaurant. He ate Scallops, which he didn’t like. He vomited and immediately started to feel dizzy. He wanted to lie down and so started crying.

Associated complaint–  Constipation since 1 week.

He is prone to catch cold easily. He was treated by conventional doctors with Singulair , ventorlin and antihistamines.

Past History– FTND. Birth weight- 7 pounds.  H/O convulsion twice at the age of 2 months. He was diagnosed as having hydrocephalus and internal haemorrhage. He was operated at 3 months of age for VP shunt. The tube connected ventricles to stomach to drain CSF.

Personal History

Thermal – Chilli

Thirst – ↓↓

Appetite – N

Desire- Chocolate, Orange juice

Aversion – Scallop which he vomited.

Sleep- sleeps through night

Perspiration -less

Stool – N. when OK

Urine – N

F/H- 3rd Child. Brother (10 yrs old) has hyperthyroidism and bronchial asthma.

Mentals- According to his mother he is an extrovert, confident and sensitive to others’ feelings.

Hobbies- Table tennis, computer

Fear – Insects, dogs

Patient lay down on the sofa in the middle of history taking. Too tired to be in front of the camera.

Investigations- CT Scan was normal. Other blood reports were normal.

Case Analysis

Miasm – Tuberculo-syphilis

Diagnoses- Narcolepsy? Chronic fatigue syndrome (which is rare for children).

Till this stage I had no clue of remedy either.

Apis is a good remedy for hydrocephalus and brain complaints in general. The other homeopath might have chosen that, but it didn’t work for him. For me the puzzle also was etiology.  Allopaths just labelled it as psycho-neurotic behaviour.  His mother was very firm that it was not psychological nor is he feigning the illness.

I started connecting the whole case together. On inquiry, I came to know that the child was always given allopathic medicines for his cold, cough or breathlessness. The previous homeopath also never inquired about his asthma. The mother thought these are two different conditions that he is suffering from, so never told the homeopath anything about it.

During history taking she realised that the attack of drowsiness came a few days after his episode of cold and cough which were treated with antihistamines and cough syrups.

With this clue, I had the path. I chose a remedy with tubercular miasm, which covers respiratory complaints, which suits the child who is sensitive, extrovert, and whose thermal is chilly.

26/02/2016 -Phophorus 200 was given.  Once at night for 3 nights.

29/02/2016 – Child was able to come to clinic for physical examination. Still not able to go to school. Managed to play with brother for 15-20 minutes.

Natrum sulph 12x – once a day for 10 days. Indication- old trauma to brain. I needed to buy time for Phosphorus to show effect. We don’t give placebo here. Biochemic is always helpful in such situations.)

Phos 200- once a week. for 3 weeks.

MRI  report was normal, showing the ventricular shunt in-situ through right parietal lobe with tip ending at the body of right lateral ventricle. Small ventricles, thin rims of subdural effusion over bilateral cerebral convexities.  No recent intracranial haemorrhage, no obstructive lesion. No other abnormality.

7/03/2016 – Child resumed school.

Phos 200- once in 15 days.

18/03/2016 –  E-mail from mother – Child came home from school with fever 38.1 C.

Adv – to give more water.

19/03/2016 – E-mail from mother – Child is fine.

Ct Phos 200 once in 15 days.

30/03/2016 – Rashes on back, neck, chest and back of knee. Itchy, red, papular rashes. Phosphorus was due on 3rd April.

Adv – Observe for any throat pain or rash getting worse. No medicine given.

1/04/2016 – Rashes settled.

!4/ 04 /2016 – C/O cold, runny nose, cough. Acute medicine prescribed as indicated.

Patient settled after this.

26/06/2016- H/O nose bleed early morning 3AM. Mother recalled that last year he had nose bleed for 45 minutes. This time it didn’t last long.

Phos 200 – stat.

After this Phos 200 was prescribed once a month for two months.

There was only one more episode of drowsiness in May. It was treated well with Phos 200. It lasted for 2 days.

No more episodes of drowsiness.

About the author

Rupal Anandpara

Rupal Anandpara

Dr. Rupal Anandpara (BHMS(Ind) PGDHA(Ind) is Hong Kong’s leading homeopathic practitioner. She obtained her Bachelor of Homeopathic Medicine and Surgery degree from the University of Pune, India. She started her homeopathic practice in 1995 and has been practicing in Hong Kong since 2001. Dr. Rupal has conducted many seminars and workshops on homeopathy. People from different nationalities and diverse cultural backgrounds come to seek her advice. Visit her website at: www.drrupal.hk https://www.facebook.com/HKHomeopathy/

Leave a Comment