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 Guillain Barre Syndrome & Homeopathy

  Dr.Sunila BHMS,MD(Hom)

Email : babuabau@gmail.com

 

 

CASE

 

Name               :           Anupama

Age                 :           12 years                       Sex                  :           Female

Place                :           Vengeri                       IP No              :           392

D O A             :           8/7/2006                      D O D             :           14/7/2006

Readmission on           21/ 7/ 2006                  D O D             :           5/ 8 / 2006

 

Presenting Complaints

 

  1. Fever   (1 Week)

  2. Weakness of Lower limbs       (1 Week)

  3. Pain in the Popliteal Fossae    (1 Week)

  4. Pain in Abdomen                    (1 Week)

 

History of Presenting Complaint

Complaint started 6 years back with fever, which continued for 6 months. Fever used to come on especially in the evening along with upper respiratory tract infection including cough and coryza. Then she developed weakness in the lower limbs which is more on walking for a long distance and which progressed so that the patient feels weak even after walking for a short distance. The weakness is better by rest. Patient used to fall down due to weakness while walking. There was pain in the lower limbs, especially on the Popliteal Fossae which increased on walking. < On ascending stairs.

 

There was also swelling of joints like wrist, elbow, fingers, ankle, knee etc. which used to come recurrently and the joints would be hot to touch with pain and difficulty in bending the joints. The patient could not hold weight or write for longer durations.

There was puffiness of eyes also. < Morning, Better in the after noon.

 

Nerve conduction test was done on 29/ 03/ 2001; diagnosed as Chronic Inflammatory Demyelinating Polyneuropathy/ Guillain- Barre Syndrome and was given Allopathic treatment for relief.

 

Now she has weakness in the lower limbs since one week and is admitted in GHMC.

 

Past History

Measles- 5 years back

Urticaria in childhood

UTI- Two years back

Took Homoeopathic treatment for all complaints and got relief.

 

Family History

 

Father has tuberculosis 

Personal History

 

Born and brought up at Vengeri. Anupama is studying in 6th standard. Her father is a painter and mother, a house wife. She has an elder sister also.

 

Generals

 

Appetite -

Thirst    - ↓

Desires cold drinks

Sleep- disturbed by dreams; cries during sleep

Stool- regular

Urine- no complaints

Desires- fish

Aversion- meat, egg, milk

Thermal reaction- chilly; she wants to cover the body always. Cannot bear cold water application

 

Regionals

 

Scalp- sensitiveness of scalp- cannot comb hair

Abdomen- Pain in abdomen < eating

Eyes- Puffiness of eyes < morning

Skin- Exfoliation of skin in the palm

 

Mind

 

She is mild, gentle, very active and enthusiastic in nature. She makes friends easily and cannot bear to be alone. When her mother goes out she is restless till she returns. She dislikes her father as he is an alcoholic, returns home drunk and quarrels with her mother. The patient cannot stand the rude behavior of her father.

 

After she and her sister were caught between a dog fight, the patient developed a fear of dogs and she has recurrent dreams of dogs. The patient is afraid of thunder storms since she was hit by a lightning and is very sensitive and fastidious.

 

Physical Examination

 

PR – 80/ mt

RR – 20/ mt

BP – 90/60 mm of Hg

 

General Survey

 

Patient is moderately built.

No pallor, No cyanosis, No jaundice and no clubbing.

Cervical lymphadenopathy present

 

Systemic Examination

 

Examination of Central Nervous system

 

Examination of higher mental functions

 

Child is conscious and alert, memory normal, no hallucination, delusion or illusion.

Speech normal, no dysarthria. Gait- Dragging (26/ 03/ 2001). Now normal steady gait.

 

 

Examination of Cranial nerves

 

Olfactory Nerve

 

No anosmia, parosmia and hallucination of smell.

 

Optic Nerve

 

There is no obstruction on the field of vision

 

Oculomotor Nerve, Trochlear Nerve, Abducens

 

Ocular movements are within normal limits

No nystagmus.

Pupil reacts to light

 

Trigeminal Nerve

 

Sensation over face is intact.

Corneal and conjunctival reflexes intact.

Jaw jerk present

 

Facial Nerve

 

Eye closure, frowning, raising the eye brow present.

Can blow, whistle and show the teeth

 

Vestibulocochlear Nerve

 

No impairment of hearing

 

Glosopharyngeal Nerves and Vagus

 

Gag reflex present.

Uvula centrally placed.

 

Hypoglossal Nerve      :

 

Can move tongue in all directions

 

Sensory System

 

With in normal limit

 

Motor System

 

                                   UL                                LL

 

Bulk                            N                                 N

 

Power                          G IV                             G IV

 

Tone                            Hypotonic                   Hypotonic

 

Beevor’s Sign              Negative

 

Superficial Reflexes

 

The plantar reflex:       Flexor Plantar Response

 

Corneal Reflex:           Present

 

Signs of Meningeal Irritation:

 

No signs of meningeal irritation

 

Investigations: 26/03/06

 

Blood

 

Hb-      11.1gm%

 

TC-      8.5x 10³ cells/ mm³

 

DC-     N43, L44, M11

 

ESR-    22 mm/ hr

 

CPK-   681 μ/L (Normal-20-200 μ/L)

(Increased in blood in muscle diseases)

 

RBS-   98 mg%

 

SK-      4.4 m eq/ L (Pottasssium serum normal, 3.5-5.2 m eq/ L)

 


 

14/7/2006

TC-      8800 cells/ mm³

 

DC-     P 36%, L 60%, E 4%

 

ESR-   60 mm/ hr

 

Hb-      12.1g%


 

Urine: RE

 

Albumin          -           Nil

 

Pus cells          -           1-2 HPF

 

Epithelial Cells-           0-1/ HPF

 

Lumbar puncture done on 26/3/01

                                                                 Normal CSF values

 

No cells seen                                   (Cells- 0-5/ mm³, all lymphocytes)

 

Proteins-          213.4 mg%             (Protein- 15-45 mg/ dl)

 

Sugar-              52 mg%                  (Glucose- 48-86 mg/dl)

 

Albumino cytological dissociation

 

Nerve Conduction Test done on 29/ 3/ 2001

 

Probably C/C inflammatory demyelinating neuropathy (CIDP)

 

Nerve Conduction Velocity Test done

 

There are prolonged distal latencies (of CMPA) both in the nerves of legs and upper limb. F waves are not obtained. The velocity of conduction is reduced. The above features are suggestive of severe demyelinating neuropathy.

 

Provisional Diagnosis

 

Demyelinating Neuropathy/ Guillain- Barry Syndrome  

 

 

Analysis of Symptoms

 

Symptoms of the patient

 

Symptoms of the Disease

 

Fear of being alone

Weakness of lower limbs

Fear of dogs

Fear of thunderstorm

Desire to work

Stumble while walking

Fastidious

Chilly patient

Sleep disturbed

Rise of temperature

Desires fish

Desires cold drinks

                                                                                           

Evaluation of Symptoms

 

Mental Generals

Physical Generals

Particulars

Common

1.Fear of dogs

 

2.Fear of being alone

 

3.Fear of thunder storm

 

4.Desire to work

 

5.Fastidious

 

1.      Chilly patient; prefers covering always

 

2.      Desires fish

 

3.      Desires cold drinks

 

1.   Evening rise of temperature

 

2.   Pain in abdomen

   < eating

 

3.   Pain in abdomen

    < morning

 

1.   Weakness of lower limbs

 

2.   Stumble while walking

 

 

 

Totality of Symptoms

 

1.      Fear of being alone

2.      Fear of dogs

3.      Fear of thunder storms

4.      Fastidious

5.      Desire to work

6.      Sleep disturbed by dreams

7.      Chilly patient

8.      Desires fish

9.      Desires cold drinks

10.  Weakness of lower limbs

11.  Stumble while walking

12.  Evening rise of temperature

13.  Pain in abdomen< Morning

14.  Pain in abdomen< After eating

Miasmatic cleavage

 

symptoms

psora

sycosis

syphilis