Types & Definitions of Epilepsy:
Epileptic seizure – convulsions accompanied by impaired consciousness
Convulsion – Violent uncontrollable contractions of muscles
Generalized seizure, grand mal, epilepsia major – A seizure during which the patient becomes unconscious and has convulsions over the entire body
Epilepsia minor, petit mal -A seizure of short duration characterized by momentary unconsciousness and local muscle spasms or twitching; “the girl was frightened by her first petit mal”
Epilepsy -A disorder of the central nervous system characterized by loss of consciousness and convulsions
CASE
Background. Master B., age 2 years 6 months was admitted in Dhaka Medical College Hospital in the Neurology department and treated for the last two and half months for epileptic seizures.
Start Of The Problem. About 4 months before, in March 2012 the boy had his 1st attack of convulsions. The duration of convulsions was for 5 -10 seconds only and 4 to 5 times a day. Gradually, the frequency of attack was on the increase. The boy was then treated by eminent neurologists of Bangladesh but, the condition did not improve. The boy was admitted in the neurology department of Dhaka Medical college(DMCH), Bangladesh Under a board of neurologists led by Prof Din Mohammad.
1st Visit & Prescription: When I visited him first in DMCH the epileptic seizure was happening at every 10 to 15 minute intervals. I decided that the absence of parents during the day and poor relationship with his grandmother may have contributed to such a problem. Accordingly I prescribed Ignatia but it did not work. The frequency of the attack remained the same.
2nd Visit & Prescription: After two days I was called to the hospital again. I tried to take the case in detail where I gathered the following symptoms:
- The boy was very clever and he can manipulate situations in his favour.
- The attack happens more during and just after the sleep.
- His father had a so-called attack of ghost in his child hood (maybe epileptic seizure).
- Mother’s side did not have any remarkable disease.
- Initiation of the disease was in the spring season.
Rubrics Considered. The following Rubrics were considered :
(Only First & Second Grade medicines are considered)
- Complete Rep 4.5, Mind, Deceitful, sly- cupr, hyos, Lach, Medo, Nat Mur,op, tarent.
- Complete Rep 4.5, Gen, Seasons, Spring aggr- AMBR, Ant T, Apis, Ars brom, aur, BELL, Bry, CALC, Cv, Cench, chel, colch, crot H, GELS, Kali bi, LACH, LYC, natm, nats, Puls, rhust, sars, sep, sil,sulph, verat,
- Complete Rep 4.5, Sleep aggr- Acon, ambr, arn, ars, camph, cv, carbn s, cv, caust, chel, cocc, con, crot H,crot t, dios, euphr, ferr, hep, hydrang, kalin,LACH, lyc, mambo,op,ph ac, phos,phyt, puls,rheum, sabad, SEL, sep, SPONG, staph, STRAM, SULPH,
The result of the repertorization was in the following order:
- Lachesis
- Natrum Mur
- Belladona
- Veratrum
- Pulsatilla
- Sulpur
Lachesis Covers the case fully.
Prescription. On 21 July 2012.
Lachesis M/2- Twice a day for 4 days. ¼ tea spoon to be taken from 2nd glass of water. Patient’s condition to be reported everyday.
Next day: 50% improvement in seizure. Sleeps better, appetite better.
3rd Day- improvement continues.
4th Day- Improvement Continues. Seizure still remains but much less.
5th Day- Lach M/3. Prescribed for 4 days, to be taken in the same way.
6th Day- Seizure still remains but much less.
7 th Day- Improvement continues
8 th Day- Improvement continues
9th Day- Seizures almost nil. Lach M/4. Was prescribed to be taken in similar way.
10th Day- Aggravation of symptoms, frequency of seizure like that of the beginning.
I ordered to stop the medicine. The seizures then subsided. Improvement in all parameters. Lachesis was not repeated. After 3 days the relatives got the patient released from DMCH.
Feedback: To this day (22 March 2018) the patient is better and has not had any seizures.
Lessons Learnt:
- Detailed case taking is essential.
- Deep acting medicines like Lachesis should not be repeated often.
