I have a pt. young , fair , flabby and gentle nature. He is a stududent of finalM.B.B.S
he is very disperate with his complaints which started a few years back .
At an early infancy he suffered poliomyelitis affecting right limb .which was recovered after various treatment .
He developed Fasiculation over whole body but more prominent in both lower limbs
He is hopeless of recovery as in alopathic science the prognosis is not good.
He sweats much.offensive sweating staining white.
Not having any habit of tobacco or alcohol
About a week when he came under my treatment he was very depressed
on cosolation and administeration of Ignatia a slight better changes was observed .
Opinion and experiences are ivited to help the young fellow

__________________
Dr.P.K.Sinha

PKS - your report is a bit brief!

Muscles twitching
Persp odourous, stinking
Persp easily
Consolation agg

Take a look at Sep and Silica.

Maybe Zincum(s) too.

Thanks anna and wexdoc
Actually even after much effort I could gather a little information .
Its a pre diagnosed case of upper mottor neuron disease with fsiculation.
The twitching , jerking sometimes shakes the body .Pt. is very much concious
anxious and desperate . As a medico he concentrate on patholgy and prognosis
as mentioned in Medicine Books . At an early age he suffered Poliomyelitis.
sweating neither aggravate nor ammeliorate salivation during sleep, Fasiculation
has no particular modality but when anxious or thinking is worse sometimes
Has not particular liking ,desliking, No emaciation. Bowel regular constipation sometimes.
He is fair fatty and flabby. Further details I shall post time to time

__________________
Dr.P.K.Sinha

Since there is jerking of the limbs as well as muscle twitching, I would use
muscles, twitching, jerking instead of just
muscles twitching

This opens the possibility of NuxV and Staph as well, presuming the other symptoms are well observed and rubrics well-chosen.

It hinges somewhat as to whether he really can be said to be worse from consolation, and I would not like to have a case of this magnitude resting on a judgement like that.

Why not give him a comprehensive questionnaire to complete so as to get the basic info and modalities?

Just taking an overview, without repertorising at all - it looks a lot like Calc Carb constitutionally. And since the whole thing is a result of suppression of poliomyelitis then that is really what you need to cure - Calc being a leading remedy for Polio.

Why not try him with a Nux 200 to clear the case a bit and at the same time give him a questionnaire to bring back in five days.

Dear Anna
Here is a good news . The pt. has started improving after Mercurius 1M which I prescribed him three days back . Why merc. I shall write you next day.

__________________
Dr.P.K.Sinha

In my last post He was given Mercurius 1M the three characteristics
Salivation during sleep, sweating offensive , Fasiculation , twitching
jerking
Clarke strongly presents the feature . The Degenearative changes
as specially nerves mostly caused by the Syphilitc Miasm
About one week has passed the pt. is static after progress .
Anna, here is the examination report for further discussion
Sehgal's Nerological Research Institute-New Delhi
File ID:MAR-8 3.3.0 09 MAR 01 16:45
MASTER PATIENT MR.H.MEDICO 16:45:23
ID MAR.-8
NAME:MR.H.MEDICO GENDER:M AGE:24 YRS
Referring physician R.S.DWIVEDEE

Patient History and Clinical Diagnosis:
Twenty four years old madical student from Dhanbad
complains of videspread fasciculation over bath lower limbs with marginal lack of endurance,gives to
assess for disease activity.

Conclusions and Interpretation:
Sensory motor conduction study of both lower limb including H responses are essentially normal.
Sensory responses in right upper limb is normal too.
Concentric needle EMG with a bandpass of 150-10k sampled muscles from all four limbs including sternomastoid. widespread,simple as well as complex fasciculations were noted virtually in all. Large,mostly stable,Mups could be sampledfrom all.Firing rate of individual units were
increased singnificantly.Interference was reduced in all.No ACTIVE
DENERVATION in the form of fibs,PSWS were seen.Polyphasia was minimal.No jiggle was conspicuous.

IMPRESSION:
EDK study suggest a diffsuse,almost uniform axon loss
lesion involving bilaterl cerical and lumnosacral segments.Pathology is
chronic,well cp,[emsated without any evidence for acute or subacute
progression.SMA is a likely possibility.

DR.ASIS BHATTACHARYA.
MD,DM(NEURO)
=================================
NEURO EMG & EP DIAGNOSTIC CENTER
MITAAHPORE "B" AREA
PATNA-800001

HISTORY :R/O Early motor neurone disease ? Benign Fasciculation

Report : EMG and NCV studies have been done in both upper & lower limbs.

EMG shows the motor unit potential (MUPS) within normal range during insertional
activity.while during maximal contraction the interference pattern not complete
and shows moderate to moderately high voltage low wave in thenar and hypothenar
muscles.Multiple high voltage biphasic or low voltage slow wave partial are noted . As
spontaneous activity in right tibialis anterior and calf muscle.

Motor nerve conduction ( MNC ) of right mediam, ulnar and radial nerve show the
compound muscle action potential ( CMAP) reduces in amplitude and area of dispresion
Same thing in noted in the left tibial and right peroneal nerve while there is reduction
of conduction velocity on both sides when nerve is stimulated of conduction velocity
is stimulated at ankel.

F-wave is significantly increased in right radial nerves.

Sensory nerve action potential (SNAP) has mild reduction amplitude and conduction
velocity in right radial nerve.

Imp :EMG and NCV studies in upper and lower limbs show sensori-motor neuropathy with
denervartion pattern potentials suggestive of mnd .Right radial sensori-motor neu-
pathy may be watched.


Dr. Ramesh Chandra
MS,MCh(Neuro),FACS.


================================
patient name : Mr. H Medico Patient ID : 19.2.2000-2001
Date : 17 Apr 2001
Gender : Male
Referring Physician : Neuro Centre Age : 24 Yrs
Examining Physician
Referred For : EMG & NCS UL/LL
----------------------------------------------------------------------------
R/O Early Motor Neuron Disease
? Benign Fasciculation In my last post He was given Mercurius 1M the three characteristics
Salivation during sleep, sweating offensive , Fasiculation , twitching
jerking
Clarke strongly presents the feature . The Degenearative changes
as specially nerves mostly caused by the Syphilitc Miasm
About one week has passed the pt. is static after progress .
Anna, here is the examination report for further discussion
Sehgal's Nerological Research Institute-New Delhi
File ID:MAR-8 3.3.0 09 MAR 01 16:45
MASTER PATIENT MR.H.MEDICO 16:45:23
ID MAR.-8
NAME:MR.H.MEDICO GENDER:M AGE:24 YRS
Referring physician R.S.DWIVEDEE

Patient History and Clinical Diagnosis:
Twenty four years old madical student from Dhanbad
complains of videspread fasciculation over bath lower limbs with marginal lack of endurance,gives to
assess for disease activity.

Conclusions and Interpretation:
Sensory motor conduction study of both lower limb including H responses are essentially normal.
Sensory responses in right upper limb is normal too.
Concentric needle EMG with a bandpass of 150-10k sampled muscles from all four limbs including sternomastoid. widespread,simple as well as complex fasciculations were noted virtually in all. Large,mostly stable,Mups could be sampledfrom all.Firing rate of individual units were
increased singnificantly.Interference was reduced in all.No ACTIVE
DENERVATION in the form of fibs,PSWS were seen.Polyphasia was minimal.No jiggle was conspicuous.

IMPRESSION:
EDK study suggest a diffsuse,almost uniform axon loss
lesion involving bilaterl cerical and lumnosacral segments.Pathology is
chronic,well cp,[emsated without any evidence for acute or subacute
progression.SMA is a likely possibility.

DR.ASIS BHATTACHARYA.
MD,DM(NEURO)
=================================
NEURO EMG & EP DIAGNOSTIC CENTER
MITAAHPORE "B" AREA
PATNA-800001

HISTORY :R/O Early motor neurone disease ? Benign Fasciculation

Report : EMG and NCV studies have been done in both upper & lower limbs.

EMG shows the motor unit potential (MUPS) within normal range during insertional
activity.while during maximal contraction the interference pattern not complete
and shows moderate to moderately high voltage low wave in thenar and hypothenar
muscles.Multiple high voltage biphasic or low voltage slow wave partial are noted . As
spontaneous activity in right tibialis anterior and calf muscle.

Motor nerve conduction ( MNC ) of right mediam, ulnar and radial nerve show the
compound muscle action potential ( CMAP) reduces in amplitude and area of dispresion
Same thing in noted in the left tibial and right peroneal nerve while there is reduction
of conduction velocity on both sides when nerve is stimulated of conduction velocity
is stimulated at ankel.

F-wave is significantly increased in right radial nerves.

Sensory nerve action potential (SNAP) has mild reduction amplitude and conduction
velocity in right radial nerve.

Imp :EMG and NCV studies in upper and lower limbs show sensori-motor neuropathy with
denervartion pattern potentials suggestive of mnd .Right radial sensori-motor neu-
pathy may be watched.


Dr. Ramesh Chandra
MS,MCh(Neuro),FACS.


================================
patient name : Mr. H Medico Patient ID : 19.2.2000-2001
Date : 17 Apr 2001
Gender : Male
Referring Physician : Neuro Centre Age : 24 Yrs
Examining Physician
Referred For : EMG & NCS UL/LL
----------------------------------------------------------------------------
R/O Early Motor Neuron Disease
? Benign Fasciculation

__________________
Dr.P.K.Sinha

Hello Dr Sinha, I was away when you posted this but just looked up the thread.

Allopathic expertise is very useful in monitoring, analysis and prognosis but not for deciding on a homoeopathic remedy.
This case is suppressed polio, and certainly there is a syphilitic element in it, as per your analysis and the temporary relief given by Merc.
A full case anaylsis of the whole constitution could shed light on the way forward. All the usual things about taking a balance of mental and physical symptoms, generals and modalities. You are an expert at spotting characteristics in a case as I have observed and those are more important than this report.
My own homoeopath reminded me that a case well-taken is half cured. Without a full case one cannot do justice to the power of homoeopathy.
Please have confidence that you can help this patient and don't be infected by his own despair. Force the case out of him!

thanks ann
bringing again this case after a long gap
I could n't read your message prviously
It is one sided complaint with least improvement I added sepia on his mental and watching

__________________
Dr.P.K.Sinha