On 20 July 2010 a 50-year-old man was brought to the clinic. He could barely keep on his feet and had to be almost carried into the consulting room by two relatives. He appeared extremely emaciated and lethargic. He was being fed via a tube through the abdominal wall.
Since February 2010 the patient had been suffering from left-sided hemiplegia. In addition there was paralysis of the swallowing muscles, which made food intake impossible for the patient, hence the feeding tube. The patient’s wife carried a plastic bag for him to spit into.
Asked about his symptoms, the patient reported: "I have had difficulty swallowing for 4 months. I cannot eat; if I force myself to, the food comes back up through my nose. I am paralysed on the left side of my body. Only my right side still works, so I can no longer do everyday things. I have a strange tingling in the right side of my face. Sometimes that side goes numb and I have no sensation there. That is very annoying. If I suddenly turn my head to the side, I become extremely dizzy. I then feel as if I am about to fall over and lose consciousness. My vision has also suffered; I see blurred and sometimes double."
Als ich ih
n bat, über den Beginn der Lähmung zu berichten, erzählte der Patient, die Symptome seien plötzlich aufgetreten. Er hätte sich gerade mit Verwandten unterhalten, als ihm plötzlich schwarz vor Augen wurde und er kollabierte. An das, was nach dem Kollaps passierte, kann er sich nicht mehr erinnern. Er war im Krankenhaus aufgewacht und konnte sein rechtes Bein und seinen rechten Arm nicht mehr bewegen.
An MRI scan dated 13/02/2010 showed a non-haemorrhagic infarct of the right lateral medulla (the diagnosis of Wallenberg syndrome was made later). Multiple lacunae with ischaemic foci in both hemispheres.
The patient describes his temperament as follows: "I get angry very quickly; even trivial things make me furious. I cannot control my anger. I then become abusive, irrespective of who I am addressing. When I become angry nobody can stop me. I do not like it when my family does not do what I tell them and does not follow my instructions. Even if someone only misplaces the TV remote, it makes me unbearably upset. I was like this as a child too; I simply did not care about others. I do not like being asked questions. When my wife asks about my work I become angry and shout at her. I do what I want – nobody can tell me what to do or not to do. I cannot stand it when anyone tries to give me advice. I do what I think is right. If someone hurts me I become angry and abusive. If I fall out with someone, I no longer speak to that person and cut off all contact. I cannot forgive anyone. I demand respect. I do not do small talk or gossip about others; I cannot stand such things. I just want to work and get on with my life. I do not pay visits to anyone, whoever it is, neighbours or relatives; I do not even visit my sister.
General physical symptoms
Temperature sensation: hot
Thirst: none
Appetite: normal
Sleep: disturbed
Desires: lemon juice; ice-cold water
Analysis
Swallowing impossible
Side: left
Insulting, abusive, reviling
Food and drink: cold drinks, craving for ice-cold drinks
Prescription: Veratrum album C200, single dose
After the first dose the patient’s vision improved. He was able to walk without assistance and grew progressively stronger. The right, very weak hand showed marked improvement, but there was no change in the left hand. In addition, both feet were now swollen. Regarding his fits of rage he reported: "I was not so angry before, but now I get so worked up that I throw things around. I become even more abusive than before when I cannot assert my will and become even angrier." His vision and the dizziness had improved, the patient was stronger, had gained weight and could walk unaided. However, his emotional symptoms remained unchanged. In fact his anger appeared to have worsened. We waited two months and prescribed Veratrum 200 (29/9/10) and Veratrum 1M (13/10/10). We were not satisfied with the course of the treatment and the prognosis for the patient, because we had expected a complete cure, which had not occurred.
We revised the case and repertorised again.
Analysis
Anger, violent
Contradiction; cannot tolerate contradiction
Side; diagonal, crosswise; right above and left below
Insulting, abusive, reviling
Anger; slight, quick-tempered; becomes
Misanthropy, hatred of people
Striking; anger, from
Anger; over trivialities
Violates people against their will
Reproof; aggravated
Reproofs; aggravated; friendly; self
Prescription: Platina C200, single dose on 10/11/10
Follow-up
8/12/2010: Since 6/12/10 the patient has been taking food again. He can swallow saliva, food and water. Vision has improved and the dizziness has disappeared. The numb feeling in the face has lessened, the mobility of hand and leg has improved. He has gained 8 kilograms. At all follow-up appointments there is improvement on all levels. The patient reports that his violent outbursts have decreased considerably and he has become much calmer. The patient continues to do well; the remedy did not need to be repeated.
Lessons we can draw from this case
In this case we could clearly see that a complete cure in the homeopathic sense only occurs when changes take place on both the physical and the emotional level. Although the patient showed marked improvement on the physical level after administration of Veratrum album, nothing changed on the emotional level even after repeated doses in various potencies. An important symptom complex of Wallenberg syndrome are the sensory deficits in the trunk and extremities on the side opposite to the actual infarct, coupled with sensory deficits in the face and cranial nerves on the same side as the infarct. Specifically there is loss of pain and temperature sensation on the contralateral (opposite) half of the body and on the ipsilateral (same) side of the face. This crossed symptom pattern is the diagnostic hallmark of the syndrome. Other clinical symptoms are swallowing difficulties, unclear speech, ataxia, facial pain, vertigo, nystagmus, Horner's syndrome, diplopia and possibly a palatal myoclonus. The diagonal side-affinity emerged as an important symptom that was not covered by Veratrum album. This again emphasises that an ordinary symptom, because of its intensity and its lateral relationship, can become a characteristic feature.
We then had to find a remedy that covered the uncontrollable rage, the lack of insight, the aversion to advice and the obstinacy of the patient. The patient could not control his anger, became abusive and threw things around. He did not enjoy company and ended relationships as soon as he felt attacked. There is only one remedy to which this symptom picture fits and Platina produced an astonishing result here.
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This article was published on www.interhomeopathy.org
Category: Cases
Keywords: Hemiplegia, diagonal complaints, Wallenberg syndrome, uncontrollable rage, ruthless.
Remedy: Platina
Photo: Shutterstock - STANZI - Headshot of an angry screaming man in the darkness.
