Management of a Case of Encephalitis with Homoeopathy

Abstract

Encephalitis an acute inflammatory disease of the brain due to direct viral invasion or to hypersensitivity initiated by a virus or other foreign protein with dysfunction of brain. Allopathic system antiviral medications only work on a limited number of viruses.

 Homoeopathy is effective both in the prevention and treatment of

Encephalitis, A confirmed and failed case which was brought to the hospital with hopeless condition, was treated successfully in Govt homoeo hospital Hyderabad with Stramonium

Keywords: Encephalitis, epidemic, latent psora, Stramonium

Encephalitis an acute inflammatory disease of the brain due to direct viral   invasion or to hypersensitivity initiated by a virus or other foreign protein with dysfunction of brain.

 Encephalitis was described in 1871.In India first epidemic was noted in 1955, at Tamilnadu. It is endemic in A.P, Karnataka, West Bengal, U.P & northeastern states. According to national institution of virology Pune half of the population in south India had neutralizing antibodies to virus. It is not unusual to have epidemics of viral encephalitis mainly Je Encephalitis post monsoon season from almost all states of the country barring a few northern Indian states.JE  virus is the only causative virus for these epidemics.

        Encephalitis may be a primary manifestation or a secondary complication of a viral infection. Viruses causing primary Encephalitis may be epidemic (arbovirus, poliovirus, echovirus, and coxsackievirus) or sporadic (herpes simplex, varicella-zoster, and mumps viruses). Mosquito-borne arboviral encephalitides (St. Louis, eastern and western equine, and California) infect humans only during warm weather. JE is a seasonal disease that occurs during the monsoon and post-monsoon periods between August and December, when stagnant water breeds mosquitoes (culex variety), which transmit the virus from pigs to human beings. Infected insects (such as mosquitoes or ticks) and animals, which can transfer some viruses directly into the bloodstream via their bite.

The deadly Japanese Encephalitis exhibits a particular pattern by striking every alternate year. It is commonly seen in children, with incubation period of 7-16 days, the child develops non specific prodromal symptoms that is fever, headache, altered sensorium, seizures focal signs and symptoms of meningial irritation and IICP. Lasting 2-3 days, neurological symptoms begin suddenly with increasing deteriorating levels of consciousness and generalized convulsions and some focal neurological signs of raised ICP, Patients run the risk of slipping into a coma.  Invasion of the brain is likely to result in neuronal necrosis, frequently with visible inclusion bodies. In Para infectious and post infectious encephalomyelitis, perivenous demyelinating lesions are characteristic.

The symptoms of JE Encephalitis include: Headache-62.4%, Altered sensorium, Fever, focal S/S ,Convulsions, Meningial-sign, Motor deficiencies , Cranial nerve involment , pyramidal signs Aphasia, Involuntary movements and Coma.

In Allopathic system antiviral medications only work on a limited number of viruses. Treatment aims to reduce the severity of the symptoms and Vaccination is the only protection against Japanese Encephalitis virus infection.

Homoeopathic concept: homoeopathy is effective both in the prevention and treatment of Je, A suspected confirmed and failed case was treated in Govt homoeo hospital Hyderabad. All the acute cases are due to explosion of latent psora. Acute miasm is a disease producing power, which causes acute, specific, infectious epidemic diseases having almost fixed manifestations. Master Kent defines acute miasm as “An acute miasm is one that comes upon the economy, passes through its regular prodromal period, longer or shorter, has its period of progress and period of decline and in which there is a tendency to recovery”.

A case report of JE Encephalitis

MA.AR, aged 13m, sex: m, IP: Case

Was brought to the hospital with hopeless condition on 16.9 with following presentation: Fever with convulsions, shaking of right. Upper limb and right. Lower limb, up rolling of eyes, vacant look.

History of presenting illness:

History of Past illness:

Birth was by cesarean section.

Family History: H/O convulsion in father’s family [1st cousin]

Treatment History: Took allopathic treatment in a nursing home for a weak with out any relief.

Physical examination:

O/E—pupils dilated, rolling of eyes, Doll’s eye reflex-+ve

Deviation of mouth to right side,

Decerebrate posture (glassco coma scale 6).

Cranial nerves----deviation of mouth to right side.

Motor system—tone increased in both sides, power is more in upper limbs

DTR- -absent, Signs of meningeal irritation+.

P/A: abdomen soft, Hepatmegaly +ve,

 Investigations:

CBP: (27/8/98)

WIDAL TEST: (26/8/98)

Poly O: 1:80

S.Tyhpi H :   1:80

S.Tyhpi AH :1:80

S.Tyhpi BH: 1:80

C S F: (27/8/98)

Glucose: 59 mg/dl ., proteins :8.4 mg/dl,

Gram stain: no microorganisms, occasional inflammatory cells,

Blood Chemistry (27/8/98)

RBS: 78mg/dl, S Calcium: 9.2mg/dl

S.creatinnnie:0. 5mg/dl, total proteins: 6.3 G/dl, Albumin: 3.8 G/dl, Globulin: 2.5 G/dl

Billrubine total: 1.6 mg/dl, Billrubine direct: 0.5 mg/dl, sodium: 143mEq/L,

Potassium:4.7 mEq/L, SGPT: 23 IU/L ,Alk Phosphatase : 280 IU/L,

Prothrombin time: 17 sec, A/G ratio: 1.5:1

CT SCAN (contrast)(27/8/98): mild changes of focal cerebral atrophy in Fronto-parital

Regions on both sides

Blood Chemistry (29/8/98)

RBS:120 mg/dl, sodium:142mEq/L, Potassium:4 mEq/L,

Diagnosis:  was based on pyrexia, absence of rash, epidemic, altered sensorium and asymmetrical symptoms. In this year (1998) 524 cases were reported in AP, with case fatality rate 38.36 in 1998.

Signs Symptoms taken for prescription:

High fever with convulsions & chills

Shaking of   rt. upper limb and rt. lower limb,

Up rolling of eyes,

Vacant look

Restless sleep,

Pupils dilated,

Cerebral irritation,

TREATMENT:

Selection of remedy:

16/09: Belladonna 200C
(in water 3 it’s, every 4th hourly was

 Given)

Progress of the case after [24 hours]

Temperature came down on 2nd day, pupils were still dilated, convulsions occurred at 8 PM, 10.30PM, 12AM- 4.30AM & 7.30AM-10.30A.M

Bowels &Urine: N, Moving the mouth to side, jerks in upper right & right lower limb, and Jerking in sleep were present. Extreme muscular mobility Pupils widely dilated twitching and jerking of the arms and lower limbs Deep sleep, comatose somnolency, Coldness of whole body, especially of limbs, < Dark, Constant restless movements of all limbs and the whole body. Perspiration with fever,

Stramonium, was selected on 18/09

Stramonium 0/1 was given in water every 6^th hourly 

Progress after Stramonium

19/09: Jerks persisted; Stramonium 0/1 in water was continued,

20/09: As child was able to swallow fluids nasal feeding was stopped, jerks reduced in intensity, child was still restless, excessive crying

On 5th day i.e. on 23/09 Stramonium was stopped, as jerks stopped.

 Progress after Stramonium [5 th day]

Involuntary jerky movements of right extremities disappeared, pupils started reacting to light, and restlessness & crying stopped,

Verbal response ++, bowels: N, urine: N. DTR -RT    (biceps, triceps, knee &ankle) ++  

 LT -N,     Rubrum was given for the next seven days.

Conclusion:

Still few people have misconceptions on homoeopathy that in emergencies homoeopathy has no role; this case which treated in homoeopathic hospital is an eye opener to the critics. This is a given up case treated with homoeopathic medicines the case was followed for four years , case initially was treated for seven days in a private nursing home, sifted to our hospital. Case recovery was miracle, but child couldn’t escape the permanent cerebral sequelae.

References:

1) Rastogi & Sharma V.D, study of homoeopathic drugs in Encephalitis Epidemic (1991) in Utter PradeshCCRH Quarterly bulletin, vol 14, (3&4) 1992.

2) Harinadham.K, Je Encephalitis and Homoeopathy, journal of Indian systems of   medicine and homoeopathy, vol-1, Jan-mar 2000, commissionerate of Indian medicine & homoeopathy, Govt of A.P.

3) Kapoor, face encephalitis with confidence, journal of the HMAI, VOL 111,

NOS 3-4, 1979, HMAI Publication.

4) Lakshminarayana & Chalapathy, Belladonna in brain fever or Encephalitis, Hahnemannian Gleanings, vol XL.V11, no6, June 1980,

5)  Behr man, Klieg man, Jenson, Nelson, text book of pediatrics, 16ted,

     Harcourt Asia ple Ltd.

 *** published in NJH,Vol 8,no 6,Nov-Dec 2006

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