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A Case of Lumbo-Sacral Prolapsed Intervertebral Disk With Paraplegia


Mr D.D.S., 47 years, a technician of a political party, came to me on 12 Dec 2012 walking with crutches supported by a partner and diagnosed as a case of paraplegia with foot drop due to Vitamin B 12 deficiency along with diffuse posterior annular disc bulge at L3-4 to L5-S1 level.

He was not able to lift his legs, feet, or toes.

He was not able to stand without the support.

He was getting numbness in thighs at night with sudden shock like sensation.

 

ODP

1995: Started as sudden falling on right or left side due to imbalance associated with tingling & numbness in lower extremities

2004: Suffered from passing involuntary urination

2008: Started getting difficulty in walking with bed wetting. Gradually, lost capacity to walk as well as stand without support

Being a technician of a Political Party, he was very loquacious having a egoistic attitude. He was quite particular, perfect and industrious in his work. He could not tolerate injustice to himself as well as others.

         

Due to his illness, he left Mumbai and went to his native place. As he was not able to work, he became bored as well as felt forsaken by people, friends, and relatives. He gradually became indifferent with everyone as the disease progressed.

On observation, he used to "frown" a lot.

 

MRI: LUMBO SACRAL SPINE 11 Jan 2002 (Hinduja)

Diffuse posterior annular disc bulge is seen from L3/4 to L5/S1 levels indenting the thecal sac.

Vitamin B 12 (29 May 2004)  

153 pg/ml (Normal 193-982 pg/ml)

Vitamin B 12 (8 Feb 2011)

446 pg/ml (Normal 193-982 pg/ml)    

 

ANALYSIS OF A CASE

  • This is gradually developing paraplegia may be due to the disc prolapse.
  • Earlier, it was considered a case of Vitamin B-12 deficiency. But, even after Vitamin B 12 supplement paralysis was increasing. His B-12 level results in 2011 were found to be quite normal. Yet, the disease continued to progress.

 

MIASM | SYPHILITIC

RUBRICS SELECTED

  1. Loquacity
  2. Egotism, self esteem
  3. Fastidious
  4. Industrious, mania for work
  5. Injustice, cannot support
  6. Escape, attempts to
  7. Ennui, boredom
  8. Forsaken feeling
  9. Indifference, apathy, Increasing gradually
  10. Extremities, Paralysis, Foot, partial
  11. Extremities, Paralysis, Legs
  12. Extremities, Paralysis, Toes, Extensors, of
  13. Extremities, Shocks, Lightening like
  14. Frown, disposed to

 

RESULT OF THE REPERTORIZATION

  1. Plumb met: 15/13
  2. Sulph: 10/9
  3. Nux vom: 11/8
  4. Aur met: 12/7
  5. Lyco: 11/7

 

HOMOEOPATHIC MANAGEMENT

  •  Physiotherapy

REMEDY PRESCRIBED (12 Dec 2011)

  •  Plumbum met 0/1 tds for 10 days.

                                              

PLUMBUM METALLICUM: Boericke’s Materia Medica

  • Drug for general sclerotic condition
  • Lead paralysis is chiefly of extensors from center to periphery with partial anesthesia or excessive hyperesthesia
  • Progressive muscular atrophy
  • Important to peripheral affections
  • The points of attack for Plumbum are the neuro-axons & anterior horns
  • Symptoms of Multiple Sclerosis & Posterior Spinal Sclerosis

 

Follow Up (23/12/11)

  •  Feet drop decreased
  •  Able to extend the lower limb with efforts
  •  Able to stand without support
  •  Feeling Hopeful about recovery
  •  Remedy continued in bd doses for 15 days

Follow Up (12/01/12)

  •  Feet drop decreased a lot
  •  Able to extend the lower limb with efforts
  •  Able to walk with stick
  •  Feeling confident about recovery
  •  Remedy continued in bd doses for 15 days

Follow Up (17/02/12)

  •  Went to Mumbai for a work of his Political Party for Corporate Elections
  •  Work hard for the same
  •  His friends astonished observing his improvement in walking
  •  Involuntary Urination decreased
  •  Bed wetting absent
  •  Able to lift his leg as well as feet
  •  Able to extend the lower limb with efforts
  •  Able to walk without stick for few foot-steps
  •  Feeling too much confident

 

  •  Advised him Spinal Extension Exercises
  •  Remedy: Plumbum Met 0/2 bd  for 15 days

 

Dr Prasad Rasal HMD (London), MD (Hom)
Sai Swami Computerized Homoeopathic Clinic, Hospital, Research Center and Maternity Home

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Replies to This Discussion

Respected Sir,

50 Millesimal potency is the most mild potency Dr Hahnemann have introduced in 6th edition of the Organon of Medicine.

In centisimal scale, concentration if the medicine is: 1/100

In 50 Millesimal scale, it is: 1/50000

For e.g: 1 Gm of the common salt is dissolved in 100 drops of water in centisimal & 1 Gm of the same is dissolved in 50000 drops of the water.

So, naturally, 50 millesimal is more diluted & milder than centisimal potency.

Aconite, Belladonna are having short action. You can sometimes repeat. But the deep acting polycrests, you should not repeat. And if there is the need of the repetition, its always better to repeat them in 50 Millesimal.

I think, I have tried to explain my level best to solve your query.

Thanks!

With regards,

Dr Prasad Rasal

You may say that the medicine is diluted or mild, means the same. According to the theory of Similimum, the medicine  should be similar. The question of potency comes afterward.  Each potency is a different medicine. The location of attack changes. Take Opium. Low potency of Opium produces constipation and sopor which is extensively used by the Allopathic brothern. We use Opium 1M to remove constipation and disease that originate from fear. Now question come up short acting and long acting medicine. One of my allopathic friend said that put the opium in a tank of water, all persons drinking water will suffer from constipation and sopor. If we put the 10M phial in the tank does the persons will be bold like a soldier, fearless? The primary action is on digestive system and mental state.  But the secondary action depends on the acceptability of Vital force. Lot of chemicals are flown by the chemical industries into river and we drink the same water. The people living in Jhugi and Jhopriy  have worst living conditions, but still they are hard laborer. Thus we have to understand the vital force and its manifestations.

Dr. S.C. Kursija, 

Very interesting explanation. Seems equally credible too.

Respected Sir,

Basically, when you are dealing with the dynamics, you can not predict the specific action of the medicine. As you have rightly said that it depends up on the reaction of the vital force i.e. nothing but the Susceptibility of the patient. It varies from person to person.

Your question was regarding the repetition of the centisimals. As centisimal scale is comparatively much stronger than the 50 millescimal scale, Dr Hahnemann have changed his views in the 6th edition of the Organon & asked to repeat this safest scale instead of centisimal.

When you are using medicines in Dynamic scale, the primary action of the medicine will be negligible. It can act as a dynamic stimulus to produce a reaction in the individual. So, if you are giving a dose of Opium in 1M potency, it will not going to produce a primary action & develop fearless & boldness. The person who consumes the Opium 1M will react to this stimulus & will produce the signs & symptoms depending on his Constitution, Miasmatic background & Susceptibility. Action will be variable from individual to individual. So, according ti Patient, we have to consider the Potency. The concept of looking towards the potency is variable from individual to individual.

This is what I understood regarding the concept of the potency.

Thanks!

Dr. Prasad, Your justification for using low potency is quite appropriate, you being confident & well conversant with the use of 50 Millesimal potencies could effectively administer Plumb 0/2 bd. But those who only use centesimal potencies, what would you advise, could Plumb 30 have been used and repeated say od or bd or even less frequently?

Respected Sir,

You can start with the centisimal i.e. Plumb 30. But you should not repeat it frequently. Being stronger in dilution & energy, the dynamicity of the centisimal scale is always too high. It is always better to repeat them cautiously depending on the depth of the action of the medicine which you have selected.

As you go on increasing the potency, the penetration of the action of the medicine is more finer. After 50 millesimal scale, if you need in depth action, its better to give the same medicine (if the state of the patient is still the same)in centisimal but in few doses.

Thanks!

Dr. PrasadArvind Rasal, 

Thanks for your feedback and response.

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