Dr neha surana on scope&limitationofhomeopathyforneurologicaldisorders

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There are number of diseases which are labeled as 'surgical', where homeopathy works curatively and can avoid surgery.

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  • Neurological disorders are one of the commonest problem in the clinical practice. This is due to the control of nervous system over all organs of the body producing symptoms of that organ and abnormality of any organ indirectly produces symptoms of nervous system. Neurological disorders are treatable in functional stage of derangement. Any cell loss is irreversible due to failure of regenerating capacity of neurons. This makes any neurological disorder untreatable in late stage. Due to the complexity of nerve cells, largest number of gene control its function. Genetic disorders also commonly affect nervous system. Homeopathy is most useful in dysfunctional stage of any disease or pre-pathological stage. Which is not uncommon in clinical practice. Neuronal plasticity or capacity to take over function of affected part is common in young and reduces with age. Any recovery of neuronal function of damaged nervous system is due to this remarkable capacity which can be stimulated by homeopathic medication. By systemic study of cases and and there response to treatment it is possible to assess the effect of treatment. Unfortunately in homeopathic literature and in common practice such analysis is not done. Second problem is of follow-up, it is common for Indians for not reporting when they improve or when they do not improve. Anecdotal case reports of successful cases are full in any alternative system but failures are not represented. Over last two years we have treated all neurological cases coming and admitting under me with homeopathy and try to analyze the response on follow-up. We have selected the cases when they best fitted in particular remedy. Constitutional remedy were given in chronic cases and key note or causative in acute cases.
  • Total 5728 neurological cases have been seen from May 1998 to August 2000 in our hospital. Homeopathc medicine were given in 1557 cases for various disorders.
  • Conventionally neurological disorders are classified in three broad groups. Neuroanatomic syndromes. Neuroclinical syndromes Neuropathologic syndromes
  • Neuroanatomic syndromes are classical way of diagnosing neurological disorders. Aim of the neurologist is to first localize the lesions. Signs and symptoms are grouped into various anatomic location as follows. Cerebral cortex – Gray and white matter Basal Ganglion and Thalamus Hypothalamus Cerebellum. Brain Stem Spinal Cord Anterior horn cell Peripheral nerve Neuromuscular junction Muscle This classification is not of much use for homeopath. Anatomic location specific homeopathic medicine are limited.
  • Neuroclinical syndromes are presenting neurological problems. They can be divided in to following headings and helps to find out the cause of the problem. Disorders of consciousness – Alteration of consciousness varies form simple inattention to deep coma or brain death. With deeming coma treatment becomes more difficult. Earlier stages of coma can be treated. Disorders of behavior and cognition: Behavioral and cognitive disorders are commonly treated by psychiatrist are best treated by homeopathy due to mental symptom without pathologic changes. Sleep disorders: These disorders are also due to neuronal dysfunction and genetic in nature can be treated by homeopathy. Disorder of speech and language: Commonly due to organic brain syndromes like stroke, tumor or abscess and homeopathy has limited role in these group of disorders. Motor weakness: Motor weakness or paralysis are one of the commonest presentation, and are due to organic pathology. Any recovery of paralyzed part is due to remyelination or neuronal plasticity. Homeopathy can be of great help in achieving this goal of nature. Expectation should be guarded with knowledge of pathological process and extent of damage. Movement disorders: These are fast and slow, Chorea, athetosis, dystonia tremor and parkinsonism. Aetiollogy and extent of pathology decide the response to any medication Epilepsy: Commonest movement disorder due to excitation of cerebral neuron due to various pathology are good cases to try homeopathy when they are not life threatening. Disorder of sensation: Pain and parenthesis are difficult to treat common neurologic problems can be treated homeopathically. Bladder and bowel dysfunction: theses are commonly organic disorder resistant to treatment. Vertigo: common disorder are responsive to homeopathy.
  • Etiology is the main basis of classification of any diseases. International classification of disease is based on etiology. Prognosis is also dependent on the etiology. Infectious disorder: Infectious disease are not common in neurology due to tight compartmentalization of brain. Ubiquitous nature and commonest cause of morbidity and mortality in developing country infection affecting brain is still not uncommon in this part of the world. Antibiotics are the greatest advance in modern medicine and infections of the nervous system have high morbidity and mortality. Any bacterial infection should be treated with antibiotics with complimentary homeopathy. Viral infection have limited treatment and homeopathy can be tried. Demyelination: Demyelination is due to damage to the myelin sheath with preservation of axon result of autoimmune process have good chance of recovery and homeopathy can be tried except in life threatening situation. Metabolic disorders: Organ failure and various electrolyte imbalance are best treated by correcting the metabolic abnormality. Homeopathy is complimentary in these disorders. Toxic disorders: Toxin producing neurologic disorders are treated by removal of toxins. Body can be assisted by homeo medication. Genetic disorders: Abnormality of gene, causing faulty production of enzyme protein and disorder of neuronal function are irreversible and only palliation can be expected. Neoplastic diseases: Tumor are chronic space taking lesion have most characteristic presentation in various part of the brain, surgical removal, radiotherapy and chemotherapy are the only unsatisfactory way of treatment Resolution of tumor has been described from time to time and homeopathy can be tried. Neuro rauma: Third common cause of death in the west and loss of tissue is instantaneous. Homeopathy is known to improve the plasticity. Vascular disorders: Vascular diseases are also common. There is no treatment after bleeding takes place. Thrombosis is also acute and homeopathic treatments not satisfactory.
  • Alteration of consciousness is a spectrum of disorder ranging from mild inattention to deep coma. Mechanism is abnormal function of reticular activating system and its projecting area of cerebrum. It is generalized failure of brain function. Causes are many from infection to toxin. Prognosis depends on the cause and extent of damage to the nervous system. Infection, metabolic and toxic disorders are potentially treatable in early stages. Causes of Coma Supratentorial Lesions Epidural or Subdural Hematoma L arge Isquemic Infarction T umor Intraparenchymal hemorrhage Trauma Abscess Infratentorial Lesions B asilar artery thrombosis Pontine or Cerebellar Hematoma Ischemic Cerebellar Infarction Tumor bscess Diffuse Encephalopathies H ypoglycemia Drug Intoxication Hepatic Encephalopathy Hyperosmolar States Hyponatremia Global Cerebral Ischemia Hyperthermia Meningitis and Encephalitis Subarachnoid Hemorrhage Myxedema Renal Failure Hypercarbia Thiamine Deficiency Hydrocephalus Psychogenic C atatonic States Acute Psychotic Deliria Hysteria-malingering Use of homeopathy should always be complimented by understanding of the mechanism of coma. Various drugs have been described and most important among them are Belladonna, Stramonium and Hyoscyamus These are toxins which produces delirium of various kind. Situation like these are not uncommon in practice but results are not consistent due to varied mechanism responsible, and spontaneous recovery is common. We have failed to show any dramatic change in theses settings. Opium is described in sleep like quite painless coma, which is very common. Repeatedly we have failed to show any significant effect of this remedy. Total no of cases 11 Male 06 Female 05 Responded 02
  • These group of disorder come under preview of psychiatrist and when cause is not clear are ideally suited for homeopathic medication. Organic brain syndrome are divided into delirium, and dementia. Delirium are early stage of coma which we have already discussed Dementia is failure of mental function leading to inability to perform social, occupational and personal tasks with normal consciousness. Causes are many from treatable transient to untreatable degenerative disorders. Knowing the cause is important to tell prognosis and the effect of treatment. Any disease which affect the brain diffusely can cause dementia. We have tried few patient medication along with medical treatment without any significant improvement. Alzheimer’s disease is one of the primary dementia where no treatment is available but our three cases did not show any improvement. Psychosis are core psychiatric disorder which needs strong antipsychotic medication. There is no permanent cure and medication have plenty of side effects. Due to relative preservation of neuron with biochemical changes theses are potentially treatable disorder with homeopathy. Lack of controlled trial and data regarding control of symptom still patients have to depend on medical treatment. Personality disorders are due genetic and environmental influence are also good candidate for homeopathy. We have treated many neurotics specially anxiety state and hysteria or conversion reaction. Two drugs are worth mentioning with very good result if symptom matches. Argenum nitricum and Ignatia. We have repeatedly used theses without failure with strict selection of cases.
  • Phobias are irrational fears and consequent avoidance of specific objects, activities or situations Agoraphobia : Fear of open or unfamiliar places Acrophobia: Fear of height Social phobia: Fear of scrutiny or fear of shameful behaviour in front of others There are many homeopathic remedies described in various kind of phobia. Theses were uncommon in neurological practice.   Generalized Anxiety disorder This is a chronic (over 6 months duration), persistent and pervasive anxiety mainly manifested by Motor tension. Sympathetic and parasympathetic symptoms: sweating, dry mouth, dizziness. Apprehension. Vigilance and scanning ( edginess, irritability, easy distractibility) Insomnia, restless sleeps and fatigue. Diagnosis is made when any three of the first four categories listed and there is no stressor evident. Homeopathic remedies Panic Disorder A panic disorder is characterized by sudden, discrete and repeated onset of a cluster of severe anxiety symptoms without an obvious phobic stimulus. Phobias cannot be associated and cannot be due to physical disorder, withdrawal or drugs or another psychiatric illness. Dyspnea Palpitation Chest pain Choking sensation Dizziness or vertigo Feeling of unreality Paresthesias Hot and cold flashes Sweating Fainting Trembling and shaking   Obsessive-compulsive disorder Obsessions are recurrent, intrusive thoughts, feeling or impulses, which are repugnant or senseless to the patient. Compulsions are stereotyped, repetitive actions, which the patient tries to resist. Various remedies has been described for different kind of phobias. We did not encounter those peculiar phobias . Aconite is good remedy for sever panic disorder, we encounter only one case over last ten year who had typical fear of death and died within few hours. There was no chance to use aconite during last 2 years. Arsenic was used as constitutional remedy for generalized anxiety disorder with mixed result. Argentum nitricum was most useful remedy for anticipation anxiety associated with various problems.
  • Hysteria term is advisable to avoid in view of varied meanings. Dissociative disorder or conversion reaction is used for a partial or complete loss of the normal integration between memories of the past, awareness of identity and immediate sensation and control of bodily movements. Conversion symptoms are transformed mental conflict and unpleasant memories that individual cannot solve. There are classified as follows Dissociative amnesia Dissociative fugue Dissociative stupor Trance and possession disorder Dissociative motor disorder Dissociative convulsion Dissociative sensory disorders Selection of homeopathic remedy depends on presentation of symptom and causation. Ignatia was most effective when it followed bereavement. We could be successful for dissociative convulsion. Aquilegia, pathos and castoreum are described as hysterical remedy without clear indication. Moschus is a remedy for hysterical fit, fainting aggravated by cold. Platina is indicated in hysterical paralysis, anesthesia. Valeriana is used for hysterical spasm.
  • Speech disorders are classified into three categories. A. Disorder of articulation -> Brain stem cranial nerve diseases B. Disorder of phonation -> Laryngeal and cranial nerve diseases C. Disorder of language -> Diseases of speech center cortical Expression problem Auditory and visual reception problem Reading writing problem Disorder of articulation are due to paralysis of lower cranial nerve or brain stem diseases. We treated them with two drugs Causticum and Gelsimium without significant improvement. Disorder of phonation are also treated with the same group of medication with no success. Language disorders are more difficult to treat and are commonly due to stroke. No particular remedy came in our mind and depending on whole symptom of the case these were treated.
  • Sleep disorders are common and insomnias are ubiquitous in elderly population. They are broadly divided into following categories Disorder of initiation and maintaining sleep – Insomnia Disorder of excessive sleepiness Disorder of excessive day time sleepiness a. Narcolepsy b. Cataplexy c. Sleep Apnea syndrome. 4. Disorder of sleep wake cycle 5. REM sleep related parasomnias 6. Sleep arousal syndromes 7. Sleep wake transition disorders We have tried paciflora and Kali phos for few insomnias without any remarkable result. Other specific sleep disorders were rare and did not find any clearly indicated remedy to treat.
  • Restless leg syndrome needs special mention due to a specific remedy associated with this disorder.
  • Restless Leg Syndrome of night kicking Essential features desire to move the extremities, often associated with paresthesias/dysesthesias unpleasant creeping sensation ;arising deep within the legs and occasionally in the arm. motor restlessness; worsening of symptoms at rest with at least temporary relief by activity.
  • Other features Sleep disturbance, Periodic limb movements in sleep and similar involuntary movements while awake, A normal neurological examination in the idiopathic form, A tendency for the symptoms to be worse in middle to older age In some cases, a family history suggestive of an autosomal dominant mode of inheritance.
  • Causes Idiopathic Anaemia Polyneuropathy Cancer Motor neuron disease
  • Zincum metallicum in various metria medica Kent Incessant and violent fidgetiness of feet in sleep and also when awake. Formication of feet and legs as from bugs crawling over the skin, preventing sleep - . Allen Key notes Excessive nervous moving of feet in bed for hours after retiring,even when asleep- Boericke Nervous motion of feet when asleep Body jerks Feet in continued motion;cannot keep still K.N.Mathur Fidgety feet,must move them constantly Twitching and trembling even during sleep
  • Features of zincum metalicum matches so much with restless leg syndrome that it can be considered as specific of this disease.
  • Our experience of use of Zincum metalicum in restless leg syndrome We have seen 22 cases during last one year period. 15 were males and 7 females. Age ranged form 35 to 55 years and duration of symptom 2-20years.
  • One each case were associated with diabetes and hypertension and 3 cases had epilepsy.
  • There were follow up with 13 cases , 11 cases showed complete recovery and 2 cases partial.
  • Case 1 Age: 51years Male Profession: Lecturer Duration of symptom: 20years Symptoms: Creeping sensation in the legs, relieved by moving or massaging leg at night with sleep disturbance (2am-10am) Treatment received : Nitrovet 5mg BD for 5years without any relief
  • Zincum met 200 one dose given on Sept 30th 98. Follow up: Symptoms improved remarkably with in two days. Patient was symptom- free after a month.
  • Age : 37years Duration of symptoms : 2years History :On 18th Oct 98 at 1am tingling sensation in the legs;fainted ,when he tried to get up to move his leg.Admitted in Apollo Hospital to investigate for Stroke. On further inquiry, these sensation were present over two years at rest, relieved by leg movement. Jerking of legs in sleep
  • Treatment: Zinc met 200 one dose After two days his symptoms disappeared completely
  • Other Homeopathic Remedies for RLS Medorrhinum : Intense restless and fidgety legs feet. Lower limbs ache all night; preventing sleep. Heaviness of legs, walking very difficult. Graphites : Fidgety while sitting at work.
  • Allopathic Treatment Benzodiazepines L-dopa and bromocriptine Opioids
  • Zincum metallicum can be considered as a specific homeopathic remedy to treat Restless Leg Syndrome .
  • Nocturnal cramp is common symptom, Calf muscle spasm at night may be primary or secondary to salt loss, renal failure, or in pregnancy. Medical treatment is use of calcium, magnicium, vitamine E with poor response. Quinine, quinidine or phenytoin is indicated in severe cses.
  • We have used cuprum metallicum single dose at night with good result 78 cases of cramps were given Cuprum metallicum, 50 were males and 28 females. 45 cases showed reduction of symptom, 9 patient did not respond and 24 patient did not follow up. 3 families with 3 members in each were also responsive to treatment. Cuprum mettalicum can be tried in primary nocturnal cramp.5 case we could stop quinine and maintain them on homeopathy.
  • About 40 percent of the brain controls motor function. Paralysis is one of the commonest manifestation of brain. Paralysis can be due to any dysfunction of motor pathway from cortex to the muscle. Causes can be any tumor, trauma, infection vascular, demyelination or degeneration. Recovery of function is directly related to the extent and the nature of the the lesion. Recovery is also dependent on the age of the patient and hence neuronal plasticity and rehabilitation or stimulation done following the paralysis. We have used causticum and gelsimium for focal paralysis and Hypericum for postraumatic spinal and brachial plexus lesion. Later drug did show some changes but first two were not very useful. Plumbum metallicum was used in various focal, generalized and classical wrist drop without any effect. Conium in ascending paralysis was ineffective. Picric acid for neuropathy was also ineffective.
  • Movement disorders are abnormal movement of the part of the body spontaneously during waking hours. Cause is usully difficult to find. Potentially treatable by homeopathy. Clinically movement disorders are classified into two group rhythmic and arrhythmic. Tremor comes under first group, it can be fast and slow. Arrhythmic movements can be fast like chorea and slow or dystonia. There may be several secondary causes, Rehumatic chorea is the commonest. Dystonia are slow movement and ideopathic group is large. There is no specific curative treatment available in allopathy. Many drugs have been described in theses disorders. We were successful in few cases of facial dyskinesia and blepherospam with agaricus. Mygale is another remedy for facial twitching with littile effect in our cases. Writers cramps were tried with mag phos without any result. Chorea and athetosis were not responsive to constitutional treatment.
  • Epilepsy is another major group of disorder in neurological practice. Seizure is defined as single episode of abnormal movement and epilepsy as recurrent seizure, or first as symptom and second as disease. Depending on the part of the nervous system irritated symptom varies form focal twitching of a muscle, abnormal sensory symptom to abnormal psychic phenomenon. When there is alteration of consciousness it is called complex partial seizure. Generalized seizure are abnormal motor movement of whole body, which can be tonic, clonic or myoclonic. Petit mal seizure are seen in children with transient unconsciousness for few seconds several times a day, precipitated by hyperventilation. EEG is confirmatory shows 3spike and slow wave per second. There are many medication described in this disorder depending upon the nature of symptom, spread and cause. We were not able to control seizure with use of constitutional of key note remedies. Two remedies are worth mentioning , Cup met which has symptom of Jacksonian march and Cicuta has classical Grand mall seizure. Both of theses medicine were not effective in our experience.
  • Abnormal sensory symptom or paresthesia are due to irritation of sensory nerves due to various cause. There is no medical treatment available for such sensation. Burning parenthesis are one of the commonest., followed by tingling numbness. There are good burning remedies in homeopathy like , sulphur, Cantheris and phosphorus, arsenic. There were few success in this situation. Tingling numbness and fornication were resistant to all form of treatment.
  • Pain is the only natural warning signal of body and should be used to find the origin of pain. Many situation pain sensation become pathological loosing its primary function and interfere with physiological function. Medical treatment in later situation is use of pain killer. Severe pathological pain due to nerve damage are usually resistant to treatment. Various homeopathic remedies has been described for pain and approach is simple modalities, causation related to associated mental symptom. We were always in search of the mental symptom and those classical medicine like Aconite, Belledona, Bryonia, Rhustox with increasing frequency. We have not come across any aconite patient. Three later medcine were not very impressive in many cases. Only effective medicine based on causation were Arnica for soft tissue injury, Ruta for tendon injury and hypericum for nerve injury.
  • Vertigo A hallucination of motion in which either the patient feels himself spinning or the surroundings spinning .
  • Vertigo Cases Duration - May’98- June2000 Total cases 321 Age - 20 to 75years Sex - F:132 : M :189
  • Types of Vertigo Vestibular 262 Cervical 48 Central 21
  • Conium Vertigo on lying down, turning over in bed, turning head sideways (esp.to left),turning eyes Treated : 123 ( 38%) Relieved : 103 ( 84% ) Unreported : 21
  • Bryonia Vertigo from motion, rising from bed. Ameliorated by lying down and head rest. Treated : 149 ( 46%) Relieved : 105 (70%) Not relieved : 15 (10%) Not reported: 29 (20%)
  • Cocculus Motion sickness (nausea with vertigo) on traveling and walking Treated : 30 (9%) Relieved : 15 (50%) Not relieved : 05 (16%) Unreported : 10
  • Borax Vertigo on looking downwards, descending steps, coming down in a lift. Treated :02 Relieved :02
  • Lachesis Vertigo on waking from sleep or in sleep; on closing eyes. Treated :01 Relieved :01
  • Summary Relieved   259 (80%) Not relieved   16 Not reported 46 Total 321  
  • Vertigo Trio Bryonia Conium Cocculus
  • Postural Hypotension
  • Postural Hypotension – Case A 45 year old diabetic male patient transferred from other hospital having severe fall in BP to 0 mm Hg on standing with repeated fall. He was given Bryonia 200,1 dose after which the patient showed immediate improvement in blood pressure
  • Postural Hypotension Fall in blood pressure more than 30mm Hg systoloic/ 20mm Hg diastolic on changing position from lying to sitting and from sitting to standing. Associated with giddiness,palpitations,sweating,swaying and fall.
  • Causes of Postural Hypotension Peripheral Diabetic neuropathy Alcoholic neuropathy Guillian-Barre syndrome Familial Central 1. Shy-Dager syndrome 2. High spinal cord transection
  • Bryonia in Postural Hypotension Cases Neurocardiac Syncope: 10 Diabetic Neuropathy: 2 Parkinsonism: 2 HIV: 1 Spinal cord Injury: 2 Total 17
  • Commonly used drugs Bryonia : 149 Giddiness on rising Arnica: 124 Soft tissue injury Conium: 123 Giddiness on head movement Cup met: 78 Cramps of calves Rhustox: 78 Fibrous tissue injury Ignatia: 76 -> emotional trauma Causticum: 55 -> Facial palsies Ars alb: 47 Constitutional Zinc met: 38 RLS/Sleep myoclonus Pulsatilla: 35 Constitutional
  • Commonly used drugs Nat.mur: 34 Constitutional Cocculus: 30 Vertigo on motion Ruta: 30 Tendon injury Lachesis: 27 Constitutional Arg.nit: 26 Constitutional Gelsemium: 25 Constitutional Hypericum: 24 Spinal Injuries Agaricus: 15 Facial twitching Sanguinaria: 10 Constitutional Cicuta: 9 Epilepsy
  • Mode of Prescribing Constitutional Causation Key note Pulsatilla Ignatia Bryonia Nat mur Aconite Conium Ars.alb Opium Cocculus Lachesis Hypericum Cup.met Arg.nit Arnica Zinc.met Gelsemium Rhustox Causticum Sulphur Ruta Agaricus Calc carb Symphytum Plumbum met Nux vomica Nat sulph Borax Lycopodium Bellis per Cicuta
  • Dr neha surana on scope&limitationofhomeopathyforneurologicaldisorders

    1. 1. Scope of Homeopathy in Neurological disorders
    2. 2. Neurological diseases in OP May 1998-August 2000 <ul><li>Neurological cases: 5728 </li></ul><ul><li>Received Homeopathy: 1,550 </li></ul>
    3. 3. Neurological disorder <ul><li>Neuroanatomic Syndromes </li></ul><ul><li>Neurocliical Syndromes </li></ul><ul><li>Neuropathologic syndromes </li></ul>
    4. 4. Neuroanatomic Syndromes <ul><li>Cerebral cortex – Gray and white matter </li></ul><ul><li>Basal Ganglion and Thalamus </li></ul><ul><li>Hypothalamus </li></ul><ul><li>Cerebellum </li></ul><ul><li>Brain Stem </li></ul><ul><li>Spinal Cord </li></ul><ul><li>Anterior horn cell </li></ul><ul><li>Peripheral nerve </li></ul><ul><li>Neuromuscular junction </li></ul><ul><li>Muscle </li></ul>
    5. 5. Neuroclinical Syndromes <ul><li>Disorders of consciousness </li></ul><ul><li>Disorders of behavior and cognition </li></ul><ul><li>Sleep disorders </li></ul><ul><li>Disorder of speech and language </li></ul><ul><li>Motor weakness </li></ul><ul><li>Movement disorders </li></ul><ul><li>Epilepsy </li></ul><ul><li>Disorder of sensation </li></ul><ul><li>Bladder and bowel dysfunction </li></ul><ul><li>Vertigo </li></ul>
    6. 6. Neuropathologic syndromes <ul><li>Infectious disorder </li></ul><ul><li>Demyelination </li></ul><ul><li>Metabolic disorders </li></ul><ul><li>Toxic disorders </li></ul><ul><li>Genetic disorders </li></ul><ul><li>Neoplastic diseases </li></ul><ul><li>Neuro trauma </li></ul><ul><li>Vascular disorders </li></ul>
    7. 7. Disorder of Consciousness <ul><li>Spectrum of alteration of consciousness </li></ul><ul><li>Inattention </li></ul><ul><li>Drowsiness </li></ul><ul><li>Stupor </li></ul><ul><li>Coma </li></ul><ul><li>Brain death </li></ul><ul><li>Causes of alteration consciousness </li></ul><ul><li>Supra tentorial diffuse structural disease </li></ul><ul><li>Infra tentorial disease </li></ul><ul><li>Metabolic disease. </li></ul>
    8. 8. Cognitive and Behavioral Disorders <ul><li>Organic brain syndrome </li></ul><ul><ul><li>Delirium </li></ul></ul><ul><ul><li>Dementia </li></ul></ul><ul><li>Psychosis </li></ul><ul><ul><li>Schizophrenia </li></ul></ul><ul><ul><li>Mania </li></ul></ul><ul><ul><li>Depression </li></ul></ul><ul><ul><li>Compulsive neurosis </li></ul></ul><ul><li>Personality disorders </li></ul><ul><li>Neurosis </li></ul><ul><ul><li>Anxiety </li></ul></ul><ul><ul><li>Hysteria </li></ul></ul>
    9. 9. Anxiety Disorders <ul><li>Phobic anxiety disorders </li></ul><ul><li>Agoraphobia </li></ul><ul><li>Social phobias </li></ul><ul><li>Specific phobias </li></ul><ul><li>Generalized anxiety disorder </li></ul><ul><li>Panic disorders </li></ul><ul><li>Homeo remedies </li></ul><ul><ul><li>Aconite </li></ul></ul><ul><ul><li>Arsenic album </li></ul></ul><ul><ul><li>Argentum nitricum </li></ul></ul><ul><ul><li>Causticum </li></ul></ul><ul><ul><li>Gelsemium </li></ul></ul><ul><ul><li>Ignatia </li></ul></ul><ul><ul><li>Phosphorus </li></ul></ul>
    10. 10. Hysteria (Dissociative disorders) <ul><li>Dissociative amnesia </li></ul><ul><li>Dissociative fugue </li></ul><ul><li>Dissociative stupor </li></ul><ul><li>Trance and possession disorder </li></ul><ul><li>Dissociative motor disorder </li></ul><ul><li>Dissociative convulsion </li></ul><ul><li>Dissociative sensory disorders </li></ul><ul><li>Homeo remedies </li></ul><ul><ul><li>Ignatia </li></ul></ul><ul><ul><li>Aquilegia </li></ul></ul><ul><ul><li>Castoreum </li></ul></ul><ul><ul><li>Moschus </li></ul></ul><ul><ul><li>Pothos foetidus </li></ul></ul><ul><ul><li>Platina </li></ul></ul><ul><ul><li>Valeriana </li></ul></ul>
    11. 11. Speech Disorder <ul><li>A. Disorder of articulation -> Brain stem cranial nerve diseases </li></ul><ul><li>B. Disorder of phonation -> Laryngeal and cranial nerve diseases </li></ul><ul><li>C. Disorder of language -> Diseases of speech center cortical </li></ul><ul><ul><li>Expression problem </li></ul></ul><ul><ul><li>Auditory and visual reception problem </li></ul></ul><ul><ul><li>Reading writing problem </li></ul></ul>
    12. 12. Sleep Disorders <ul><li>Disorder of initiation and maintaining sleep – Insomnia </li></ul><ul><li>Disorder of excessive sleepiness </li></ul><ul><li>Disorder of excessive day time sleepiness </li></ul><ul><ul><li>Narcolepsy </li></ul></ul><ul><ul><li>Cataplexy </li></ul></ul><ul><ul><li>Sleep Apnea </li></ul></ul><ul><li>Disorder of sleep wake cycle </li></ul><ul><li>REM sleep related parasomnias </li></ul><ul><li>Sleep arousal syndromes </li></ul><ul><li>Sleep wake transition disorders </li></ul>
    13. 13. Restless Leg Syndrome
    14. 14. Restless Leg Syndrome <ul><li>Essential features </li></ul><ul><li>desire to move the extremities, often associated with paresthesias/dysesthesias </li></ul><ul><li>unpleasant creeping sensation ;arising deep within the legs and occasionally in the arm. </li></ul><ul><li>motor restlessness; </li></ul><ul><li>worsening of symptoms at rest with at least temporary relief by activity. </li></ul>
    15. 15. Restless Leg Syndrome <ul><li>Other features </li></ul><ul><li>Sleep disturbance, </li></ul><ul><li>Periodic limb movements in sleep and similar involuntary movements while awake, </li></ul><ul><li>A normal neurological examination in the idiopathic form, </li></ul><ul><li>A tendency for the symptoms to be worse in middle to older age </li></ul><ul><li>In some cases, a family history suggestive of an autosomal dominant mode of inheritance. </li></ul>
    16. 16. Restless Leg Syndrome causes <ul><li>Idiopathic </li></ul><ul><li>Anaemia </li></ul><ul><li>Polyneuropathy </li></ul><ul><li>Cancer </li></ul><ul><li>Motor neuron disease </li></ul>
    17. 17. Zincum metallicum <ul><li>Kent </li></ul><ul><ul><li>Incessant and violent fidgetiness of feet in sleep and also when awake. </li></ul></ul><ul><ul><li>Formication of feet and legs as from bugs crawling over the skin, preventing sleep - . </li></ul></ul><ul><li>Allen Key notes </li></ul><ul><ul><li>Excessive nervous moving of feet in bed for hours after retiring,even when asleep- </li></ul></ul><ul><li>Boericke </li></ul><ul><ul><li>Nervous motion of feet when asleep </li></ul></ul><ul><ul><li>Body jerks </li></ul></ul><ul><ul><li>Feet in continued motion;cannot keep still </li></ul></ul><ul><li>K.N.Mathur </li></ul><ul><ul><li>Fidgety feet,must move them constantly </li></ul></ul><ul><ul><li>Twitching and trembling even during sleep </li></ul></ul>
    18. 18. Z incum metallicum = Restless Leg Syndrome
    19. 19. RLS Cases <ul><li>Period: Sept 99-June 2000 </li></ul><ul><li>No of cases : 22 </li></ul><ul><li>Male:Female: 15:7 </li></ul><ul><li>Age: 35-55years </li></ul><ul><li>Duration of symptoms: 2-20years </li></ul>
    20. 20. Associated diseases <ul><li>Hypertension 1 </li></ul><ul><li>Diabetes mellitus 1 </li></ul><ul><li>Epilepsy 3 </li></ul>
    21. 21. Outcome <ul><li>Complete recovery: 11 </li></ul><ul><li>Partial recovery: 02 </li></ul><ul><li>No follow up: 09 </li></ul>
    22. 22. Case 1 <ul><li>Age: 51years Male </li></ul><ul><li>Profession: Lecturer </li></ul><ul><li>Duration of symptom: 20years </li></ul><ul><li>Symptoms: Creeping sensation in the legs, relieved by moving or massaging leg at night with sleep disturbance (2am-10am) </li></ul><ul><li>Treatment received : Nitrovet 5mg BD for 5years without any relief </li></ul>
    23. 23. Case 1 Treatment <ul><li>Zincum met 200 one dose given on Sept 30th 98. </li></ul><ul><li>Follow up: Symptoms improved remarkably with in two days. </li></ul><ul><li>Patient was symptom- free after a month. </li></ul>
    24. 24. Case 2 <ul><li>Age : 37years </li></ul><ul><li>Duration of symptoms : 2years </li></ul><ul><li>History :On 18th Oct 98 at 1am tingling sensation in the legs;fainted ,when he tried to get up to move his leg.Admitted in Apollo Hospital to investigate for Stroke. </li></ul><ul><li>On further inquiry, these sensation were present over two years at rest, relieved by leg movement. Jerking of legs in sleep </li></ul>
    25. 25. Case 2 Treatment <ul><li>Treatment: Zinc met 200 one dose </li></ul><ul><li>After two days his symptoms disappeared completely. </li></ul>
    26. 26. Other Homeopathic Remedies for RLS <ul><li>Medorrhinum : Intense restless and fidgety legs feet. Lower limbs ache all night; preventing sleep. Heaviness of legs, walking very difficult. </li></ul><ul><li>Graphites : Fidgety while sitting at work. </li></ul>
    27. 27. Allopathic Treatment <ul><li>Benzodiazepines </li></ul><ul><li>L-dopa and bromocriptine </li></ul><ul><li>Opioids </li></ul>
    28. 28. <ul><li>Zincum metallicum can be considered as a specific homeopathic remedy to treat Restless Leg Syndrome . </li></ul>
    29. 29. Nocturnal Cramp <ul><li>Spasm of calf muscle at night disturbing sleep </li></ul><ul><li>Primary familial </li></ul><ul><li>Secondary </li></ul><ul><ul><li>Salt loss </li></ul></ul><ul><ul><li>Pregnancy </li></ul></ul><ul><ul><li>Renal failure </li></ul></ul><ul><li>Medical treatment </li></ul><ul><ul><li>Magicium </li></ul></ul><ul><ul><li>Calcium </li></ul></ul><ul><ul><li>Vit E </li></ul></ul><ul><ul><li>Quinine </li></ul></ul><ul><ul><li>Quinidine </li></ul></ul><ul><ul><li>Phenytoin </li></ul></ul><ul><li>Homeopathic Tretment </li></ul><ul><ul><li>Cuprum Metallicum </li></ul></ul>
    30. 30. Cuprum Metallicum in Cramp <ul><li>Total cases 78 </li></ul><ul><li>Male 41 </li></ul><ul><li>Females 39 </li></ul><ul><li>Result </li></ul><ul><ul><li>Improved 45 </li></ul></ul><ul><ul><li>No impovement 09 </li></ul></ul><ul><ul><li>No follow up 24 </li></ul></ul>
    31. 31. Motor Weakness <ul><li>Site of lesion </li></ul><ul><ul><li>Cortical subcortical </li></ul></ul><ul><ul><li>Brain stem </li></ul></ul><ul><ul><li>Spinal cord </li></ul></ul><ul><ul><li>Anterior horn cell </li></ul></ul><ul><ul><li>Nerve </li></ul></ul><ul><ul><li>Myoneural junction </li></ul></ul><ul><ul><li>Muscle </li></ul></ul><ul><li>Causes </li></ul><ul><ul><li>Trauma </li></ul></ul><ul><ul><li>Tumor </li></ul></ul><ul><ul><li>Infection </li></ul></ul><ul><ul><li>Vascular </li></ul></ul><ul><ul><li>Degenerative </li></ul></ul><ul><ul><li>Demyelination </li></ul></ul><ul><li>Syndromes </li></ul><ul><ul><li>Quadriplegia </li></ul></ul><ul><ul><li>Hemiplegia </li></ul></ul><ul><ul><li>Paraplegia </li></ul></ul><ul><ul><li>Monoplegia </li></ul></ul><ul><ul><li>Focal </li></ul></ul>
    32. 32. Movement disorder <ul><li>Rhythmic </li></ul><ul><ul><li>Tremor – Fast and slow </li></ul></ul><ul><li>Arrhythmic </li></ul><ul><ul><li>Fast </li></ul></ul><ul><ul><ul><li>Chorea </li></ul></ul></ul><ul><ul><li>Slow </li></ul></ul><ul><ul><ul><li>Dystonia </li></ul></ul></ul><ul><ul><ul><li>Athetosis </li></ul></ul></ul><ul><ul><li>Mixed </li></ul></ul><ul><ul><ul><li>Dyskinesis </li></ul></ul></ul><ul><li>Medical treatment </li></ul><ul><ul><li>Beta blocker </li></ul></ul><ul><ul><li>Halloparidole </li></ul></ul><ul><ul><li>Pacitan , </li></ul></ul><ul><ul><li>Beclofen </li></ul></ul><ul><ul><li>Botox toxin </li></ul></ul>
    33. 33. Epilepsy <ul><li>Focal </li></ul><ul><ul><li>Motor </li></ul></ul><ul><ul><li>Sensory </li></ul></ul><ul><ul><li>Psychic </li></ul></ul><ul><li>Generalized </li></ul><ul><ul><li>Major </li></ul></ul><ul><ul><ul><li>Tonic </li></ul></ul></ul><ul><ul><ul><li>Clonic </li></ul></ul></ul><ul><ul><ul><li>Myoclonic </li></ul></ul></ul><ul><ul><ul><li>Tonic clonic </li></ul></ul></ul><ul><ul><li>Minor </li></ul></ul><ul><ul><ul><li>Petit Mal </li></ul></ul></ul><ul><li>Complex partial </li></ul><ul><li>Focal motor </li></ul><ul><ul><li>Cup met </li></ul></ul><ul><li>Generalized tonic clonic: </li></ul><ul><ul><li>Cicuta: </li></ul></ul><ul><ul><li>Absinthium </li></ul></ul><ul><ul><li>Hydrocyanic acid </li></ul></ul>
    34. 34. Disorder of Sensation <ul><li>Paresthesias </li></ul><ul><ul><li>Tinglingling numbness </li></ul></ul><ul><ul><li>Burning </li></ul></ul><ul><li>Causes </li></ul><ul><ul><li>Peripheral nerve </li></ul></ul><ul><ul><li>Central </li></ul></ul><ul><ul><li>Psychogenic </li></ul></ul>
    35. 35. Pain
    36. 36. Headache
    37. 37. Backache
    38. 38. Vertigo <ul><li>A hallucination of motion in which either the patient feels himself spinning or the surroundings spinning . </li></ul>
    39. 39. Vertigo Cases <ul><li>Duration - May’98- June2000 </li></ul><ul><li>Total cases 321 </li></ul><ul><li>Age - 20 to 75years </li></ul><ul><li>Sex - F:132 : M :189 </li></ul>
    40. 40. Types of Vertigo <ul><li>Vestibular 262 </li></ul><ul><li>Cervical 48 </li></ul><ul><li>Central 21 </li></ul>
    41. 41. Conium <ul><li>Vertigo on lying down, turning over in bed, turning head sideways (esp.to left),turning eyes </li></ul><ul><li>Treated : 123 ( 38%) </li></ul><ul><li>Relieved : 103 ( 84% ) </li></ul><ul><li>Unreported : 21 </li></ul>
    42. 42. Bryonia <ul><li>Vertigo from motion, rising from bed. Ameliorated by lying down and head rest. </li></ul><ul><li>Treated : 149 ( 46%) </li></ul><ul><li>Relieved : 105 (70%) </li></ul><ul><li>Not relieved : 15 (10%) </li></ul><ul><li>Not reported: 29 (20%) </li></ul>
    43. 43. Cocculus <ul><li>Motion sickness (nausea with vertigo) on traveling and walking </li></ul><ul><li>Treated : 30 (9%) </li></ul><ul><li>Relieved : 15 (50%) </li></ul><ul><li>Not relieved : 05 (16%) </li></ul><ul><li>Unreported : 10 </li></ul>
    44. 44. Borax <ul><li>Vertigo on looking downwards, descending steps, coming down in a lift. </li></ul><ul><li>Treated :02 </li></ul><ul><li>Relieved :02 </li></ul>
    45. 45. Lachesis <ul><li>Vertigo on waking from sleep or in sleep; on closing eyes. </li></ul><ul><li>Treated :01 Relieved :01 </li></ul>
    46. 46. Summary
    47. 47. Vertigo Trio <ul><li>Bryonia </li></ul><ul><li>Conium </li></ul><ul><li>Cocculus </li></ul>
    48. 48. Postural Hypotension
    49. 49. Postural Hypotension - Case <ul><li>A 45 year old diabetic male patient transferred from other hospital having severe fall in BP to 0 mm Hg on standing with repeated fall. </li></ul><ul><li>He was given Bryonia 200,1 dose after which the patient showed immediate improvement in blood pressure </li></ul>
    50. 50. Postural Hypotension <ul><li>Fall in blood pressure more than 30mm Hg systoloic/ 20mm Hg diastolic on changing position from lying to sitting and from sitting to standing. </li></ul><ul><li>Associated with giddiness,palpitations,sweating,swaying and fall. </li></ul>
    51. 51. Causes of Postural Hypotension <ul><li>Peripheral </li></ul><ul><ul><li>Diabetic neuropathy </li></ul></ul><ul><ul><li>Alcoholic neuropathy </li></ul></ul><ul><ul><li>Guillian-Barre syndrome </li></ul></ul><ul><ul><li>Familial dysautonomia </li></ul></ul><ul><li>Central </li></ul><ul><ul><li>1. Shy-Dager syndrome </li></ul></ul><ul><ul><li>2. High spinal cord transection </li></ul></ul>
    52. 52. Bryonia in Postural Hypotension Cases <ul><li>Neurocardiac Syncope: 10 </li></ul><ul><li>Diabetic Neuropathy: 2 </li></ul><ul><li>Parkinsonism: 2 </li></ul><ul><li>HIV: 1 </li></ul><ul><li>Spinal cord Injury: 2 </li></ul><ul><li>Total 17 </li></ul>
    53. 53. Commonly used drugs <ul><li>Bryonia : 149 Giddiness on rising </li></ul><ul><li>Arnica: 124 Soft tissue injury </li></ul><ul><li>Conium: 123 Giddiness on head movement </li></ul><ul><li>Cup met: 78 Cramps of calves </li></ul><ul><li>Rhustox: 78 Fibrous tissue injury </li></ul><ul><li>Ignatia: 76 -> emotional trauma </li></ul><ul><li>Causticum: 55 -> Facial palsies </li></ul><ul><li>Ars alb: 47 Constitutional </li></ul><ul><li>Zinc met: 38 RLS/Sleep myoclonus </li></ul><ul><li>Pulsatilla: 35 Constitutional </li></ul>
    54. 54. Commonly used drugs <ul><li>Nat.mur: 34 Constitutional </li></ul><ul><li>Cocculus: 30 Vertigo on motion </li></ul><ul><li>Ruta: 30 Tendon injury </li></ul><ul><li>Lachesis: 27 Constitutional </li></ul><ul><li>Arg.nit: 26 Constitutional </li></ul><ul><li>Gelsemium: 25 Constitutional </li></ul><ul><li>Hypericum: 24 Spinal Injuries </li></ul><ul><li>Agaricus: 15 Facial twitching </li></ul><ul><li>Sanguinaria: 10 Constitutional </li></ul><ul><li>Cicuta: 9 Epilepsy </li></ul>
    55. 55. Mode of Prescribing Constitutional Causation Key note Pulsatilla Ignatia Bryonia Nat mur Aconite Conium Ars.alb Opium Cocculus Lachesis Hypericum Cup.met Arg.nit Arnica Zinc.met Gelsemium Rhustox Causticum Sulphur Ruta Agaricus Calc carb Symphytum Plumbum met Nux vomica Nat sulph Borax Lycopodium Bellis per Cicuta
    56. 56. Thank You Dr. Neha Surana ,   Sumati Polyclinic, 6 Dealing Corner, Opp Sambhaji Park, Jangali Maharaj RD, Jangali Maharaj Road, Pune - 411004 India   Phone: +9120-25538904 Mobile: +91 9881156677   Visiting hours at Sumati Homeopathy polyclinic - Noon: 12 PM to 2PM, Evening: 5 PM to 7 PM     Email :  drnehasurana87@gmail.com Skype: drnehasurana87 Twitter:drnehasurana87( https://twitter.com/#!/drnehasurana87 ) Linkedin: http://www.linkedin.com/profile/edit?trk=hb_tab_pro_top

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