Dr Madhushree R
Abstract: A form of facial paralysis known as Bell’s palsy causes the affected side of the face to momentarily lose control over its facial muscles. In most cases, the weakness is temporary and improves over weeks. Major possible complications of the condition are chronic loss of taste, chronic facial spasm, facial pain and corneal infections.
Case of Bell’s palsy in a 55-year-old male admitted to in-patient ward in Government homoeopathic medical college and hospital, Bengaluru presented with complaint of Pain in left side of head and face, Deviation of angle of mouth to right side, Tongue deviated to left side, Pain and difficulty in closing left eye, Difficulty in puffing right cheek and raising left eye brow. Initially Spigelia 200 3 doses for 3 days was given, pain in left side of face and head got reduced in 3 days, but there was no improvement in other symptoms.so A detail case taking was done, followed by repertorisation lead to the Prescription of Lachesis. This case treated with homoeopathic medicines showed remarkable improvement in a very short period of time.
Keywords: Case report, Homoeopathy, Bell’s palsy, Lachesis.
Introduction: Bell’s palsy is an acute, apparently isolated, lower motor Neuron facial palsy for which no cause can be found. Presumed to be viral due to HSV 1 (viral genomic sequences Detected)1.
Associated known clinical conditions are Diabetes, Severe hypertension, last trimester of pregnancy, dental anesthesia. The risk factors are Exposure to cold, edema and Subsequent compression of nerve trunk within the rigid fallopian canal causes circulatory disturbance. And other important causes of acute facial palsy include Suppurative otitis media, Herpes zoster, Head injury, Guillain-Barre Syndrome, Sarcoidosis and Multiple sclerosis.1
The clinical presentation of the disorder is a rapid onset, unilateral, lower motor neuron-type facial weakness with accompanying symptoms of postauricular pain, dysgeusia, subjective change in facial sensation and hyperacusis. This clinical presentation can be explained by the anatomical construct of the human facial nerve, specifically its mixed nerve profile containing motor, sensory and parasympathetic fibres. The propensity for the facial nerve to form numerous connections with adjacent cranial nerves
The onset of Bell’s palsy is Sudden, following exposure to chill or without any apparent precipitating cause, maximum paralysis in 24 hours. Postauricular pain is common and may precede paralysis By 2 days. There may be spontaneous complaints of loss of Sense of taste, hyperacusis and watering of the eye. Sweating less on affected side.1
Forehead cannot be wrinkled; frowning lost (frontalis).Eye cannot be closed (orbicularis oculi, sphincter of Palpebral fissure). On attempting closure, eyeball turns upwards and outwards (Bell’s phenomena). On showing the teeth, the lips do not separate on affected side. Whistling not possible. Articulation of labial components difficult. Nasolabial fold flattened out. Angle of mouth on affected side droops with dribbling of saliva (Orbicularis oris, sphincter of oral fissure). Cheek puffs out with expiration because of buccinator Paralysis. Food collects between teeth and paralysed Cheek. Fluid runs out while drinking (buccinator). Base of tongue lowered (stylohyoid and posterior belly Of digastric).Vesicles within the external auditory meatus and ear Drum in Ramsay Hunt syndrome. Pain may precede Facial weakness. Deafness may result.1
CASE:
Preliminary Data
- Name- xyz
- Age- 55 Years
- Sex- Male
- Occupation- Carpenter
- Marital status- Married
- Religion- Hindu
- Address- Bangalore
- Date of IPD Admission- 12/05/2023
Presenting complaint
- Pain in left side of head and face
- Deviation of angle of mouth to right side
- Tongue deviated to left side
- Pain and difficulty in closing left eye
- Difficulty in puffing right cheek
- Difficulty in raising left eye brow
- All complaints since 1 day
History of Presenting complaint
Patient was apparently healthy, suddenly started with left side headache and twitching of left eye and then Patient noticed deviation of angle of mouth to right side ,tongue deviation to left. followed by difficulty in puffing right cheek and raising left eye brow.
Past history
- No Allergic and surgical history
- Medical history- Patient was admitted to homoeopathic hospital for osteoarthritis of knee. and his complaint was better after taking treatment.
Personal history
- Diet –Mixed
- Appetite- Good, 3times/day
- Thirst- One litre / day, Thirstless, Prefers cold water
- Desires- Spicy foods
- Aversions- Nothing specific
- Bowel movements-one time/ day, Satisfactory
- Micturition- 5-6 times a day, no burning or itching
- Perspiration- Whole body on exertion
- Sleep- Good, refreshing
- Dreams- of Snakes
- Thermals- Hot patient
Life space investigation and mind
Patient was Born and brought up in Mandya , hails from middle class family, was not interested in studies somehow studied till 10th standard. But couldn’t pass the examination. After that he was not going for any work. He got married at the age of 27 years, it was love marriage, he loved her so much but that women was in love with someone else so she left him after 3 days of marriage. He felt disappointed and he thought of ending his life by Drowning. But he didn’t attempt for it. After 15 days he was forced to Marry another women, she was his relative. They got married but patient was not happy about it. But as day passed he forgot about the first marriage. Presently he has 2 children, happily living with them.
After marriage they came to Bangalore and he started working as carpenter, there according to him he doesn’t believe anyone blindly , before talking to anyone he makes sure how is the nature of the opposite person, accordingly he will make adjustment and speaks. he told we need to be careful in this world. And he doesn’t allow his wife or children to speak with neighbours. He feels our surroundings, society is not good, so we should be careful.
In his childhood days, once while playing near Water reservoir , his friend pushed him to the water. from then he has fear of water and he can not take hot water bath, if he does, he will be sitting quiet and he will not be knowing what is happening around him for about half an hour. Since this DAM Incident Patient has fear to go near Dam, lakes or falls. He has fear of Playing in water, he cannot see large volume of water, he will not be knowing about the consequences. According to his wife he will be sitting quiet for sometime then he becomes normal
Repertorisation Proper
- Mind- Cautious
- Mind- Fear-water,of
- Face- Paralysis
- Generals- Warm bathing –agg
Repetorial Result
- Lach- 6/4
- Sulph- 5/4
- Gels- 6/3
- Hyos- 6/3
Prescription
12/05/2023 Spigelia 200 OD for 3 days
15/05/2023 Lachesis 1M 1 Dose
30/05/2023
- There is no Pain in left side 0f the face and head,can able to close left eye completely.
- Deviation of angle of mouth and tongue deviation got corrected
- There is no difficulty in puffing right cheek and raising left eye brow.
Basis of Prescription
Initially patient was having much pain in left side of face and head spigelia 200 was prescribed as neuralgia of the fifth nerve is very prominent in its effects.2as there was no improvement in other symptoms, based on the analysis of mental generals, physical generals, Particulars and reportorial result Lachesis was prescribed.
The Lachesis was not only the single remedy covering all the rubrics but also covers the mentals and basic disposition of the patient. Potency 1M was selected based on susceptibility and condition of the disease.1 dose was given on empty stomach. patient showed remarkable changes with in 15 days after the medicine.
REFERENCES:
- Golwalla AF, Golwalla SA, Nadkar MY. Golwalla’s Medicine for Students: A Reference Book for the Family Physician. Jaypee Brothers Medical Publishers; 2017 Apr 30.
- Boericke W. Pocket manual of homoeopathic Materia Medica & Repertory: comprising of the characteristic and guiding symptoms of all remedies (clinical and pathogenetic [sic]) including Indian Drugs. B. Jain publishers; 2002.
- Synthesis repertory mobile application.
Dr Madhushree R
PG Scholar, Department of Materia medica
Government Homoeopathic Medical College and Hospital, Bengaluru- 560079
madhumadhu17301@gmail.com
Under the Guidance of Dr Vijay Krishna V
Professor and PG Guide
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