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MESIAL TEMPORAL SCLEROSIS

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Title: MESIAL TEMPORAL SCLEROSIS


1
MESIAL TEMPORAL SCLEROSIS
  • REVERSED SYMPTOMS
  • WITH HOMOEOPATHY
  • Dr. Aparna Singh

2
LEFT MTS where the arrow points at the lesion
  • ATROPHY AND GLIOSIS OF THE NEURONAL CELLS

3
17/07/2014
  • WAS PUT ON ANTI-EPILEPTIC DRUGS, EVEN WHEN THERE
    WERE NO SEIZURES- Max Hosp Neurophysician

4
NEURONAL LOSS
  • The condition called mesial temporal sclerosis is
    closely related to temporal lobe epilepsy, a type
    of partial (focal) epilepsy in which the seizure
    initiation point can be identified within the
    temporal lobe of the brain. Mesial temporal
    sclerosis is the loss of neurons and scarring of
    the deepest portion of the temporal lobe and is
    associated with certain brain injuries.

5
Brain damage from traumatic injury, infection, a
brain tumor, a lack of oxygen to the brain, or
uncontrolled seizures is thought to cause the
scar tissue to form, particularly in the
hippocampus, a region of the temporal lobe. The
region begins to atrophy neurons die and scar
tissue forms. This damage is thought to be a
significant cause of temporal lobe epilepsy. In
fact, 70 percent of temporal lobe epilepsy
patients have some degree of mesial temporal
sclerosis. It also appears that the mesial
temporal sclerosis can be worsened by additional
seizures.
6
Possible Causes
  • Aging
  • Although the hippocampal sclerosis is relatively
    commonly found among elderly people (10 of
    individuals over the age of 85 years),
    association between this disease and ageing
    remains unknown.

7
Vascular risk factors
  • There were also observations that hippocampal
    sclerosis was associated with vascular risk
    factors. Hippocampal sclerosis cases were more
    likely than Alzheimer's disease to have had a
    history of stroke or hypertension, evidence of
    small vessel disease but less likely to have had
    diabetes mellitus

8
Socioeconomic status
  • Socioeconomic correlates of health have been well
    established in the study of heart disease, lung
    cancer, and diabetes. Many of the explanations
    for the increased incidence of these conditions
    in people with lower socioeconomic status (SES)
    suggest they are the result of poor diet, low
    levels of exercise, dangerous jobs (exposure to
    toxins etc.) and increased levels of smoking and
    alcohol intake.

9
Symptoms
  • Mesial temporal sclerosis usually results in
    partial (focal) epilepsy. This seizure disorder
    can cause a variety of symptoms such as strange
    sensations, changes in behavior or emotions,
    muscle spasms, or convulsions, memory loss. The
    seizures usually are localized in the brain, but
    they may spread to become generalized seizures,
    which involve the entire brain and may cause a
    sudden loss of awareness or consciousness.

10
Symptoms
  • Generally, hippocampal sclerosis comes with
    epilepsy. It is clarified the nature of insults
    that most likely cause hippocampal sclerosis and
    initiate the epileptogenic process. Apart from
    the chronic nature of epilepsy, hippocampal
    sclerosis was shown to have an important role in
    internal cardiac autonomic dysfunction. Patients
    with left hippocampal sclerosis had more severe
    parasympathetic dysfunction as compared with
    those with right hippocampal sclerosis. In young
    individuals, it is commonly recognized as Mesial
    temporal sclerosis with Temporal Lobe
    Epilepsy(TLE). On the other hand, it is an often
    unrecognized cause of cognitive decline,
    typically presenting with severe memory loss.

11
Diagnosis
  • The changes associated with mesial temporal
    sclerosis are usually identifiable on a magnetic
    resonance imaging (MRI) scan.

12
Conventional Treatment
  • ANTI EPILEPTIC DRUGS
  • SURGERY-The assessment of the extent of mesial
    temporal sclerosis is important because it can be
    a good indicator of the outcome for patients
    undergoing temporal lobectomy to control
    seizures. For this procedure, the part of the
    brain containing the point at which the seizures
    start is removed. The best outcomes for the
    surgery are in patients with mesial temporal
    sclerosis on only one side of the brain. Also,
    the best outcomes are achieved with complete
    removal of the sclerotic medial temporal
    structures. This is the single most common
    surgery for patients with medically refractory
    epilepsy, has a high rate of eliminating seizures
    and is associated with a low incidence of
    significant new neurological impairments.

13
NOW THE CASE IN PARTICULAR
  • A 38 yr old male , overweight , had been seeing
    me for the past 10 years off and on for his
    health issues, mainly ureteric calculi, and pain
    renal region, at times left and other times
    right. Had been excreting calculi till 1 yr ago.
    He has been now in the habit of chewing gutka,
    paan masala for the past 6-8 yrs and also takes
    alcohol daily, for the past 3-4 years.Eats rich
    food and is a non vegetarian, no exercise, also
    has a fatty liver.

14
ONSET
  • On 13th July 2014, Sunday, he took a tab in the
    morn-allop. To check the loose stools which he
    had in the morning, the same evening his
    daughters heavy board fell on his toe and he was
    in extreme pain and rushed to some local allop
    physician who prescribed analgesics. On 15th July
    noon as he was riding his bike, he experienced
    some abnormal sensation of fluttering, in the
    left side of chest and immediately stopped his
    bike and stood. He went on having the sensation
    for about 2-5 minutes and then subsided , only to
    re occur every 20 min to 30 minutes, he rushed
    the same night to synergy hospital and was
    admitted for observation for the night for any
    cardiac cause. Next day , was discharged and told
    that ECG is normal and it is not related to
    cardiac cause. Aft paying the bill of 15 K he
    came back.

15
Case (contd.)
  • On 17th July 2014, he noticed that he was also
    having a slur in his speech , while this episode
    of feeling cold, and almost shuddering with
    coldness of left side of the body only , a wave
    like sensation originating from chest and moving
    both up and down on left limbs and towards face
    with piloerection of hair of arm and lacrimation
    from left eye. So I went to see a neuro in Max.
    He advised MRI- in which a neurological disorder
    was confirmed-LEFT MTS.

16
NOTES BY MAX NEURO
  • Dr Rohtash sharma was the neurophysician, he is
    well known in Doon now ?

17
PRESCRIPTION BY MAX NEURO
  • ANTI EPILEPTICS DRUGS HAVE BEEN PRESCRIBED

18
IN HIS OWN WORDS
  • 22nd July 2014
  • 6 months ago also I had some complaints, of
    ghabrahat etc, which I neglected and it got
    better on its own.
  • NOW I HAVE THIS LEFT SIDED COMPLAINT
  • SHIVERING FEELING WITH GHABRAHAT FROM CHEST
    TRAVELS TO UPPER LIMB AND LOWER LIMB
  • bolne mei ladkhadahat , bhi hoti hai saath saath
    ,
  • pehle cold lagta hai , shivering hoti hai
  • FEAR HOTA HAI , DARR LAGTA HAI, ghabrahat I feel
    in chest region
  • WITHDRAWAL OF ALCOHOL AND TABACCO.. Aft that day
    have stopped taking alcohol and tobacco

19
PEAK OF SUMMER AND NO FAN/A.C
  • Since it is peak of summers, I want to have the
    right side of body under A.C , and left side
    covered by blanket, these sensations are coming
    every 20 min, under blanket and covers, little
    longer period of say 30 min. I am not even able
    to use fan because I feel cold on my left side
    and the whole episode reappears more frequently
    if I use fan.

20
My family and I are in great distress, since I
have been told by neuro that I am not supposed to
drive, since I may black out and fall from a
scooter, my car may meet an accident under Anti
epileptics.Since I am taking these drugs, now
even if a dog barks, I get startled, I dont want
to hear the sound of t.v. I feel sleepy and
misearble aft these drugs.
21
GELSEMIUM IS THE PERFECT MATCH
  • Gelsemium 200 was given by mouth and aft this one
    dose , he said the next episode came aft 40
    minutes and the intensity of symptoms was less-
  • he felt less cold
  • the wave started from chest but didnt go into
    limb, only ascended upwards, piloerection was
    there but less in intensity
  • Lacrimation lasted for less time and was also
    less
  • Slur of speech also less,
  • Ghabrahat was there and episode went off earlier
    than prev episodes.

22
BRAIN AFFECTIONS OF
  • Bry, Nux vom, Gels are the 1st 3 rems

23
J.H CLARKE- Amaurosis. Anterior crural neuralgia.
Aphonia. Astigmatism. Bilious fever. Brain,
affections of. Cerebrospinal meningitis.
Choroiditis. Colds. Constipation. Convulsions.
Deafness. Dengue fever. Diarrhoea. Diphtheria.
Dupuytrens contraction. Dysentery. Dysmenia.
Emotions, effects of. Epilepsy. Eyes, affection
of. Fever. Fright. Gonorrhea. Hay-fever.
Headache. Heat, effects of. Heart, diseases of.
Hydro-salpingitis. Hysteria. Influenza.
Intermittent fever. Jaundice. Labour. Liver,
affection of. Locomotor ataxia. Measles.
Meningitis. Menstruation, painful, suppressed.
Metrorrhagia. Myalgia. Neuralgia. Nystagmus.
OEsophagus, stricture of. Paralysis. Paralysis
agitans. Paraplegia. Pregnancy, albuminuria of.
Ptosis. Puerperal convulsions. Remittent fever.
Retina, detachment of. Rheumatism. Sexual excess,
effects of. Sleep, disordered. Spasms.
Sun-headache. Sunstroke. Teething.
Tic-douloureux. Tobacco, effects of. Tongue,
affections of. Toothache. Tremors. Uterus,
affections of. Vertigo. Voice, loss of.
Writers cramp.
24
Neurotic symptoms in cigar-makers, impotence,
palpitation. Aggravation. Damp weather before
a thunderstorm mental emotion or excitement bad
news tobacco smoking when thinking of his
ailments when spoken to of his loss.
25
24th July shifted to LM
  • On 24th July he reported relief, but said that
    the wave is still coming, albeit in a lesser
    intensity.
  • Due to persistence of symptoms he was shifted to
    LM potencies of GELSEMIUM LM2 bd .

26
STOPPED AFT 3 DAYS, on 26th July 2014
  • Aft 3 days of Gelsemium LM2 , given twice a day-
    I feel much better
  • The wave sensation is almost gone
  • Dont feel cold, no piloerection on arms and legs
  • No slur, no lacrimation
  • But on 4th day I felt symptoms increasing again
  • STOP GELS LM2 ONLY ON SAC LAC AFT THAT.

27
6th NOV 2014
  • Till 6th Nov 2014, he was on sac lac and then
    started to c/o
  • Left sided headache always worse aft sleeping
  • Even if I sleep in daytime, I get this headache
  • Morn when I wake up I get this headache of dull
    aching nature, feel sleepy and groggy, with a
    feeling of palpitation.An hour aft I wake up it
    gets better, I have stopped sleeping in daytime,
    even though I want to.

28
LACHESIS LM2
  • Based on left sidedness of headache,
  • And
  • Worse AFTER SLEEP , either day or night.
  • LACH LM2 was given bd

29
LATER MRI
  • In Jan 2015 MRI was done in Delhi, which revealed
    same findings of atrophy and left MTS. Another
    MRI was done in Jan 2015 itself, to see the
    vascularity, blood flow to the brain, which was
    absolutely normal, no obstruction of any vascular
    channel.

30
JOINED JOB IN JAN 2015
  • He has again joined back , has got a better raise
    and a better job.
  • He is not experiencing any of the previous
    symptoms .

31
WHAT IS TO BE LEARNT HERE
  • A SIMPLE MEDICINE CAN CURE/INITIATE CURE EVEN OF
    A COMPLICATED DISORDER.
  • MIASM CONSIDERATION IS NOT NECESSARY, WHEN THE
    TOTALITY IS CHARACTERISTIC AND SPEAKS FOR THE
    REMEDY.
  • DELETE FROM THE MIND DISEASE REMEDY RELATIONS-
    like for viral/seasonall flus, gels ars acon etc,
    for joint pains, rhus tox, .WHO KNEW THAT
    REVERSAL OF NEURONAL DAMAGE MANIFESTATIONS CAN BE
    INITIATED BY YELLOW JASMINE.
  • EVEN A HOMOEOPATH CAN BUNGLE CASE IF TOTALITY IS
    NOT CONSIDERED.( If Miasm is considered in lieu
    of totality)
  • ATROPHY/SCAR IN BRAIN REMAINS-SYMPTOMS VANISH.
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