Scope and limitation of homeopathy for neurological disorders

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Scope and limitation of homeopathy for neurological disorders

  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 Borax Nat sulph Nux vomica Plumbum met Symphytum Calc carb Causticum Rhustox Gelsemium Agaricus Ruta Sulphur Cicuta Bellis per Lycopodium Zinc.met Arnica Arg.nit Cup.met Hypericum Lachesis Cocculus Opium Ars.alb Conium Aconite Nat mur Bryonia Ignatia Pulsatilla Key note Causation Constitutional
  56. 56. Thank You

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