Epilepsy Homoeopathic Approach

Dr Shubhaprada S Gothe

Definition : Seizure is a paroxysmal event due to abnormal excessive or synchronous  activity in the brain. Depending on the distribution of electrical discharges in the brain , this abnormal brain activity can have various manifestation ranging from dramatic convulsive activity to experiential phenomena , not readily discernible by an observer.

Epilepsy describes a condition in which person has recurrent seizures due to a chronic, underlying process. This definition implies that a person with a single seizure or recurrent seizures due to correctable or avoidable circumstances, not necessarily have epilepsy.

Epilepsy is not contagious. Although many underlying disease mechanisms can lead to epilepsy, the cause of the disease is still unknown in about 50% of cases globally, with the highest incidence occurring in early childhood and late adulthood.

The causes of epilepsy are divided into the following categories: structural, genetic, infectious, metabolic, immune and unknown. Examples include:

• brain damage from prenatal or perinatal causes (e.g. a loss of oxygen or trauma during birth, low birth weight);
• congenital abnormalities or genetic conditions with associated brain malformations;
• a severe head injury;
• a stroke that restricts the amount of oxygen to the brain;
• an infection of the brain such as meningitis, encephalitis or neurocysticercosis,
• certain genetic syndromes; and
• a brain tumour.

Epilepsy accounts for a significant proportion of the world’s disease burden, affecting around 50 million people worldwide. The estimated proportion of the general population with active epilepsy (i.e. continuing seizures or with the need for treatment is between 4 -10 per 1000 people. Close to 80% of people with epilepsy live in low- and middle-income countries.This is likely due to the increased risk of endemic conditions such as malaria or neurocysticercosis, birth-related injuries; and variations in medical infrastructure, the availability of preventive health programms and accessible care.

Characteristics of seizures vary and depend on where in the brain the disturbance first starts,   and how far it spreads. Temporary symptoms occur, such as loss of awareness or consciousness, and disturbances of movement, sensation (including vision, hearing and taste), mood, or other cognitive functions. People with epilepsy tend to have more physical problems (such as fractures and bruising from injuries related to seizures), as well as higher rates of psychological conditions, including anxiety and depression

A fundamental principle is that seizures may be either focal or generalized.

Homoeopathy is a holistic science which focuses on overall wellbeing of an individual. Individualised remedy  is the mainstay of Homoeopathic treatment , thus improving the quality of life in patients with epilepsy.

Most cases of idiopathic epilepsy fall into the homeopathic category of “one-sided diseases”, in which only one symptom presents or one symptom is so dominant that it overshadows any others that may be present. Homeopathically, this presents a challenge, so different strategies are needed to select the curative remedy.

Taking the case includes the symptoms of the convulsions, possible causes in the individual, any concomitant symptoms and considering the individual predisposition, mental picture and physical symptoms.

Hahnemann discusses about treatment of one sided diseases in aphorism 171-182 .

• 173
  The only diseases that seem to have but few symptoms, and on that account to be less amenable to cure, are those which may be termed one-sided, because they display only one or two principal symptoms which obscure almost all the others. They belong chiefly to the class of chronic diseases.
• 175
  In one-sided diseases of the first kind it is often to be attributed to the medical observer’s want of discernment that he does not fully discover the symptoms actually present which would enable him to complete the sketch of the portrait of the disease.
• 176
  There are, however, still a few diseases, which, after the most careful initial examination (§§ 84-98), present but one or two severe, violent symptoms, while all the others are but indistinctly perceptible.

The following authors have mentioned about Homoeopathic treatment of Epilepsy in their works:

1.Dr J .H Clarke in his ‘The Prescriber’, quotes that, General condition of the patient must always be considered.

Epilepsy will after be removed by medicines homoeopathic to the general conditions when medicines chosen according to the characteristic of the convulsions alone would have no influence.

The following remedies are recommended on the supposition that the convulsions are the only , or at any rate the only serious departure from health.

RECENT EPILEPSY:

• Falls insensible, turns blue, violent dyspnea – Kali cyan.3 8h
• Recent in young sanguine subjects , Bell ,1x-3,6h
• Epilepsy with mental hebetude- with cerebral congestion, coming on at each menstrual period, – Kali brom 30, 8h
• Petit mal, Absinth 3,8h
• Violent convulsions, frightful distortions, of eyes and limbs opisthotonus, Cic.v 3,6h
• Violent convulsions, rigidity, foaming at the mouth – Ceonanth, crocus 3x,6h
• CHRONIC EPILEPSY- In general , Bufo 6,8h.
• In pale , lymphatic subjects, Calcc,6,8h .
• Fits during sleep , nervous irritability-
• Infantile epilepsy – ( during the seizure) – Flushed face – prominent throbbing fontanelle- excitement without signs of congestion – ,Zinc. Sulph 3,1h

Dr C M Boger writes  on Epilepsy in his Synoptic key of Materia medica as

1. Convulsions. see Spasmodic.

Convulsions, bending backwards : Ang., Ign.

Convulsions, choreiform : Bell., Caust., Cup., Ign., Lach., Nux-v.

Convulsions, consciousness, with :Cina., Ign., Stram.

Convulsions, unconsciousness, with : Calc-c., Canth., Cic., Hyo., Plb.

Convulsions, internal : Caust., Cocc., Hyo., Ign., Ip., Mag-m., Nux-v., Pul., Stan.

Convulsions, menses, during : Cup., Plat.

Convulsions, tonic :Bell., Cam., Cic., Ign., Ip., Op., Sec-c.

2. Spasmodic or convulsive effects, twitchings, jerks, etc. (Comp. Paroxysms.) :

Agar., Amb., Ars., Bell., Calc-c., Cam., Caust., Cham., Chin., Cic., Cimi., Cina., Cup., Hyo., Ign., Ip., Kali-c., Lach., Mez., Nux-v., Op., Plat., Plb., Pul., Sil., Stan., Stram., Sul., Thu., Ver-v., Zin.

Spasmodic or convulsive effects, twitchings, jerks, etc. during sleep :

Ars., Bell., Kali-c., Sep., Sil., Sul.

2. Dr William Boericke in his Pocket Manual Of Homoeopathic Materia medica and Repertory writes as

NERVOUS SYSTEM  GENERALITIES

CONVULSIONS — Absinth., Acon., Æth., Agar., Alum. sil., Antipyr., Arg. n., Ars., Art. v., Atrop, Bell., Camph., Can. ind., Canth., Carb. ac., Castor., Cham., Chloroform, Cic. mac., Cic., Cim., Cina, Cocc., Cupr. ac., Cupr. ars., Cupr. m., Dulc., Euonym., Gels., Glon., Helleb., Hydroc. ac., Hyper., Hyos., Ign., Illic., Iris fl., Kali br., Laburn., Laur., Lonic., Lyssin, Mag. p., Morph., Nat. s., Nux v., Œnanthe, Op., Ox. ac., Passifl., Phos., Physost., Plat., Plumb. chrom., Plumb., Santon., Sil., Solan. c., Solan. n., Stram., Strych., Sul., Upas art., Upas t., Ver. a., Ver. v., Verbena, Zinc. m., Zinc. oxy., Zinc. s.

CAUSE AND TYPE

Anger affects mother’s milk — Cham., Nux v.
Apoplectic; in inebriates; hæmorrhagic or broken down systems — Crot.
Carphopedal — Cupr. ac., Ign.
Cataleptic — Cic., Mosch.
Cerebral sclerosis or tumor — Plumb. m.
Children, infants, from reflex causes, dentition (See Worms.) — Absinth., Acon., Æth., Art. v., Bell., Calc. c., Camph. monobr., Caust., Cham., Chloral, Cic., Cina, Cocc., Cupr. m., Cyprip., Glon., Helleb., Hydroc. ac., Hyos., Ign., Kali br., Kreos., Laur., Mag. p., Meli., Mosch., Nux v., Œnanthe., Op., Santon., Scutel., Stann., Stram., Zinc. m., Zinc. sul.
Clonic — Antipyr., Apis., Bell., Camph., Carb. ac., Cina, Cupr. m., Gels., Hyos., Ign., Nicot., Plumb. m., Upas art.
Crying; approach of strangers — Op.
Exanthemata — Acon., Bell., Glon., Thea, Ver. v.
Suppressed — Apis, Ars., Cupr. m., Op., Stram., Zinc. m., Zinc. s.
Foot sweat, suppressed — Sil.
Fright — Acon., Cupr. m., Hyos., Ign., Op., Stram.
Fright, anger or emotional disturbance in nervous, plethoric persons — Kali br.
Grief, or any emotional excitement — Ign.
Hypochondriacal — Mosch., Stann.
Hysterical — Absinth., Asaf., Asar., Castor., Caul., Cim., Cocc., Gels., Hydroc. ac., Hyos., Ign., Kali p., Mosch., Nux m., Plat., Stann., Tar. h.
Injury — Cic., Hyper.
Isolated groups of muscles — Acon., Cic., Cina, Cupr., Ign., Nux v., Stram., Strych.
Labor (See Female Sexual System.) — Acon., Bell., Cic., Cupr. m., Glon., Hyos., Ign., Kali br., Œnanthe, Stram., Ver. v.
Meals followed by vomiting, shrieking, spasms — Hyos.
Menses suppressed (See Female Sexual System.) — Gels., Millef.
Metastases, from other organs — Apis, Cupr., Zinc. m.
Prodromata — Acon., Bell., Cham., Ipec., Op.
Reflected light from water, mirror — Bell., Lyssin, Stram.
Sleep, loss of — Cocc.
Spinal origin — Acon., Cic., Cim., Hydroc. ac., Hyper., Ign., Nux v., Œnanthe, Physost.
Terminal stage — Op., Plumb., Zinc. m.
Tonic: Opisthotonos — Apis, Cic., Cina, Cupr. ac., Curp. m., Hydroc. ac., Ign., Ipec., Mag. p., Mosch., Nicot., Nux v., Physost., Plat., Plumb. m., Solan. c., Solan. n., Stram., Strych., Upas, Ver. v.
Uremic (See Urinary System.) — Carb. ac., Cic., Cupr. ars., Glon., Helleb., Hydroc. ac., Kali br., Merc. c., Œnanthe, Op., Plumb., Piloc., Urt.
Uterine disease — Cim.
Vaccination — Sil., Thuya.
Whooping cough — Cupr. m., Kali br.
Worms — Cic., Cina, Hyos., Indigo., Kali br., Sabad., Santon., Spig., Tanac.

CONCOMITANTS
Beginning
Face [in]; unilateral; shallow breathing — Cina.
Fingers [in], toes, radiates all over — Cupr. m.

Bladder, chest, intestines, striated muscles, cheifly involved; drowsiness rigid limbs; sudden onset; head hot, feet cold — Bell.
Calves of legs; clenched thumbs; cyanosis — Cupr. m.
Chorea-like — Sticta.
Convulsive jerkings, of limbs and head — Bufo, Cham., Cic., Hyos.
Cyanosis — Cupr. ac., Hydroc. ac.
Extremities cold — Bell., Helleb., Hydroc. ac., Nicot., Œnanthe.
Eyes

Half open, upturned; breathing, deep, stertorous — Op.
Turned downward — Æth.

Fever; skin hot, dry; child frets, screams, gnaws its fists; twitching of single muscles — Acon.

Collapse [followed by] — Nicot.
Deep sleep [followed by] — Cupr. ac., Op., Zinc. m.
Paresis [followed by] — Acon., Elaps., Lonic., Plumb. m.
Restlessness [followed by] — Cupr. m.

No cerebral congestion — Ign.
No fever — Ign., Mag. p., Zinc. m.
Pale face; rolling eyes; gnashing teeth — Zinc. m.
Preceded,

Gastro-intestinal symptoms [by] — Æth., Cupr. ars.
Restlessness [followed by] — Arg. n., Hyos.

Shrieks, screams, before, and during — Apis., Cina, Cupr. m., Helleb., Op.
Terrible pains — Plumb. chrom.
Tremor, spasm of glottis, febrile paroxysm — Ign.
Twitchings

Cramps, gastro-enteric symptoms — Nux v.
Of single muscles or groups, especially of upper body — Stram.
Over entire body — Cic., Hyos.
Worse upper body, continue after delivery — Cic.

Violent vomiting — Æth., Upas.
With consciousness — Cina, Nux v., Plat., Stram., Strych.
Without consciousness — Bell., Calc. c., Cic., Cupr. ac., Cupr. ars., Cupr. m., Glon., Hydroc. ac., Hyos., Mosch., Œnanthe, Op., Stram.
Worse from touch, motion, noise — Cic., Ign., Lyssin, Nux v., Stram., Strych.

REFERENCES:

1. Harrison’s Principles of Internal Medicine, 21^st
2. Who.int- Epilepsy
3. ilae.org
4. The Prescriber Dr J H Clarke
5. Synoptic Key by Dr C M Boger
6. Pocket Manual of Homoeopathic Materia medica by Dr William Boericke

Dr Shubhaprada S Gothe
MD Part I , Department of Materia medica
Under the guidance of Dr Renuka S Patil
HOD Department of Materia medica
Government Homoeopathic Medical College and Hospital ,Bengaluru
shubhagothe97@gmail.com