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Left Mesial Temporal Sclerosis: Scarring In Temporal Lobe Of Brain

CASE PRESENTATION: Left Mesial Temporal Sclerosis: Scarring In Temporal Lobe Of Brain

A male aged 38 years presented with the diagnosis of LEFT MESIAL TEMPORAL SCLEROSIS OF THE TEMPORAL LOBE IN MRI REPORT and was experiencing very weird and peculiar symptoms. To see the case in detail kindly click the PowerPoint at the bottom of the page. This presentation was presented in IIHP Dehradun on March 22, 2015.

SUMMARY: On the day he came to me, I stopped his anti-epileptic drugs, which he had been taking for a week.

Left Mesial Temporal Sclerosis: Scarring In Temporal Lobe Of Brain

Mesial Temporal Sclerosis Reversed Symptoms With Homeopathy
by Dr Aparna Singh



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

17/07/2014
Patient WAS PUT ON ANTI-EPILEPTIC DRUGS, EVEN WHEN THERE WERE NO SEIZURES- Max Hospital Neurologist


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.


BACKGROUND

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.

POSSIBLE CONTRIBUTING FACTORS
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 aging remains unknown.


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

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.

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.



SYMPTOMS

  • Generally, hippocampal sclerosis comes with epilepsy. It is clarified by 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.

DIAGNOSIS

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

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.

THE HOMEOPATHIC CASE TAKING

  • 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 one year ago.

  • He has been in the habit of chewing gutka, paan masala for the past 6-8 years and also takes alcohol daily for the past 3-4 years. He eats rich food and is a non vegetarian, no exercise, also has a fatty liver.

ONSET

  • On the morning of 13th July 2014, Sunday, he took an allopathic tablet.  To check the loose stools which he had in the morning, the same evening his daughter’s heavy board fell on his toe and he was in extreme pain and rushed to some local allopathic physician who prescribed analgesics.

  • At noon on 15th July 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, which 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, he was discharged and told that ECG was normal and it was not related to cardiac cause. Aft paying the bill of 15 K he came back.
  • On 17th July 2014, he noticed that he was also having a slur in his speech, while during this episode he was feeling cold and almost shuddering with coldness of left side of the body only. He described a wave-like sensation originating from his chest and moving both up and down on left limbs and towards face with pilo-erection of hair of arm and lacrymation from left eye.  I went to see a neuro physician in Max. He advised MRI - in which a neurological disorder was confirmed - LEFT MTS.

NOTES BY MAX NEURO

  • Dr Rohtash Sharma was the well known neurophysician in Doon 
  • PRESCRIPTION BY MAX NEURO: ANTI EPILEPTICS DRUGS HAVE BEEN PRESCRIBED


IN HIS OWN WORDS 22nd July 2014

  • 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. After that day have stopped taking alcohol and tobacco


PEAK OF SUMMER AND NO FAN/A.C

  • Since it is peak of summers, I want to have the right side of my 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.
  • My family and I  are in great distress, since I have been told by neurologist 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 don’t want to hear the sound of t.v. I feel sleepy and misearble after these drugs.

GELSEMIUM IS THE PERFECT MATCH

  • Gelsemium 200 was given by mouth and after this one dose, he said the next episode came after 40 minutes and the intensity of symptoms was less-
  • He felt less cold. The wave started from chest, but didn’t go into limb, only ascended upwards, pilo-erection was there but less in intensity. Lacrymation lasted for less time and was also less. Slur of speech also less,
  • Ghabrahat was there and episode went off earlier than previous episodes.


BRAIN AFFECTIONS OF- when you see in repertory-

  • Bry, Nux vom, Gels are the 1st 3 remedies

  • 1st PARAGRAPH IN CLARKE'S MM- UNDER GELSEMIUM.
    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. *Dupuytren’s *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.
  • 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.

CHANGE OF POTENCY

  • On 24th July Gelsemium shifted to LM
  • On 24th July he reported relief, but said that the wave was still coming, albeit in a lesser intensity.
  • Due to persistence of symptoms he was shifted to LM potencies of GELSEMIUM LM2 bd.
  • STOPPED AFTER 3 DAYS, on 26th July 2014
  • After 3 days of Gelsemium LM2 given twice a day patient reports: "
I feel much better. The wave sensation is almost gone. Don’t feel cold, no pilo-erection on arms and legs. No slur, no lacrymation. But on 4th day I felt symptoms increasing again"

CHANGE REMEDY: STOP GELS LM2 GIVE ONLY ON SAC LAC AFTER THAT.

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


CHANGE REMEDY: LACHESIS LM2

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

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.

JOINED JOB IN JAN 2015

  • He has again returned back to work and has got a better raise and a better job. He is not experiencing any of the previous symptoms .


LESSONS FROM THIS CASE

  • What is to be learned? A simple medicine can cure/initiate cure even in 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/seasonal influenzas, Gelsemium, Arsenicum, Aconite, etc for joint pains, rhus toxicondron.
  • Who knew that reversal of neuronal damage manifestations can be initaed by yellow jasmine?
  • Even a homeopath can bungle a case if the totality is not considered. (If the miasm is considered in lieu of totality)
  • Atrophy/Scar in brain remains, however, symptoms vanish.

MESIAL TEMPORAL SCLEROSIS.pptx

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Dear Dr Aparna. Congratulations on presenting this case to the homeopathic community and sharing with HWC members. The presentation was clear with good explanation and images. We appreciate to learn the "management" of the case and your wisdom in knowing when to change potencies and remedy selection, as well, as investigation to Materia medica to confirm remedy.

Thanks Debby , this patient showed a remarkable recovery in a very short span of time, the most disturbing symptoms got better by almost 100%  in just 4 days. This was a wonder for me too.. :)

He took to drinking liquor and also tobacco chewing , and came back again a month ago for headache aft sleep. Then again a dose of Lach 200 cured that. Then aft a week , he experienced a sharp pain in the right renal region , and it was a ureteric colic, Nux vomica 1M relieved that pain, aft which the calculus descended and got lodged in the external urethra just 2 inches proximal to the ext.meatus, he experienced a throbbing pain there, a burning sensation in urine and then was relieved by Ars alb 30 one dose, aft which this pain and burning urine subsided and next day he passed a small calculus, the size of a lemon seed, while urinating. Now he is fine, have asked him to quit the tobacco and liquor habit .

Dear Dr Aparna - Thank you for follow up information on patient progress. How to motivate patients to quit tobacco and liquor habits when they are so addictive and cause chemical and hormonal changes within the body?

Good case indeed. Thanks for the inspiration.

Thank you so much for sharing Dr Aparna

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