A 10-year-old child presented with bilateral lateral rectus palsy (eye turning inward) that developed after an episode of emotional distress two months prior. A single dose of the homeopathic remedy Staphysagria 1M showed reduction in squinting within a month. A second dose seven months later removed the squint completely over the course of treatment. The case demonstrates how homeopathy can effectively treat ophthalmological and neurological conditions.
A 10-year-old child presented with bilateral lateral rectus palsy (eye turning inward) that developed after an episode of emotional distress two months prior. A single dose of the homeopathic remedy Staphysagria 1M showed reduction in squinting within a month. A second dose seven months later removed the squint completely over the course of treatment. The case demonstrates how homeopathy can effectively treat ophthalmological and neurological conditions.
Original Description:
A Case of Lateral Rectus Palsy by Dr Sunil Kannada
Original Title
A Case of Lateral Rectus Palsy by Dr Sunil Kannada
A 10-year-old child presented with bilateral lateral rectus palsy (eye turning inward) that developed after an episode of emotional distress two months prior. A single dose of the homeopathic remedy Staphysagria 1M showed reduction in squinting within a month. A second dose seven months later removed the squint completely over the course of treatment. The case demonstrates how homeopathy can effectively treat ophthalmological and neurological conditions.
A 10-year-old child presented with bilateral lateral rectus palsy (eye turning inward) that developed after an episode of emotional distress two months prior. A single dose of the homeopathic remedy Staphysagria 1M showed reduction in squinting within a month. A second dose seven months later removed the squint completely over the course of treatment. The case demonstrates how homeopathy can effectively treat ophthalmological and neurological conditions.
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The key takeaways are that lateral rectus palsy can have various causes like trauma, infections, tumors etc. and can be managed through medications, prisms, occlusion or surgery. This case report discusses a homeopathic perspective and treatment using Staphysagria for a case of lateral rectus palsy.
The most common causes of lateral rectus palsy discussed are vascular issues like hypertension and diabetes in adults, and trauma, tumors or infections in children.
Recovery is possible over time depending on the cause. Improvement may occur with prisms, occlusion or medications like botulinum toxin or steroids. Surgery like transposition methods may be needed. Spontaneous recovery is expected within 6 months.
A Case of Lateral Rectus Palsy
Dr Sunil Kannada, BHMS
Chief Medical Officer (H), In charge DGHD Hindustani Dawakhana, Ballimaran, Directorate of AYUSH, Govt. of NCT of Delhi. Email:[email protected]
Abstract A 10 years old child was seen with bilateral lateral rectus palsy, more marked on the left side. The parents of the child dated the squint to an episode of emotional distress about two months earlier. A single dose of homoeopathic remedy, Staphysagria 1M, showed reduction in squinting in the child within a month. Second dose of the same remedy, repeated three months later, removed the squint completely in a span of seven months. Homoeopathic treatment can therefore be useful in ophthalmological and neurological conditions.
Introduction Lateral rectus palsy (LR palsy) occurs due to weakness of abducens nerve (6 th
cranial nerve) which presents as a kind of squint, in which the affected eye is turned inwards (towards the nose).The patients presenting with LR palsy are not able to maintain alignment of eyes in all directions of gaze (incomitant variety of squint) and hence may experience diplopia(1). The children may not complain of diplopia but if left untreated may develop amblyopia.
Since the nerve has a long course from brain stem to the lateral rectus muscle of eye, numerous other neurological structures may be involved, and the patient may have other associated complaints viz. hearing loss, droopy eyelid (ptosis), facial weakness etc.
Aetiology The most common causes of LR palsy in adults and children are: Adults: 1. Vasculopathic: Hypertension, Diabetes Mellitus, Atherosclerosis etc. 2. Trauma 3. Idiopathic Children: 1.Trauma 2. Neoplastic 3. Idiopathic Viral infections, Increased intracranial pressure, Giant cell arteritis, Cavernous sinus mass, Multiple sclerosis, Vasculitis, Sarcoidosis, Post lumbar puncture or myelography etc. are the less common causes.
Recovery and case management It is possible for cases of LR palsy to spontaneously improve over a period of time depending upon the cause viz. viral infections can recover completely whereas post traumatic may have residual effects depending on severity of trauma. However, it is generally expected that maximum improvement takes place during the first 6 months of onset of complaints. Improvement may also take place with use of Fresnel Prisms or by occluding vision of the affected eye. Medicinally, Botulinum toxin injection is given to the ipsilateral Medial rectus to weaken it or steroids in other conditions. Surgically Hummelsheims transposition or Jensens (2,3,4)
method may be required.
Homoeopathic perspective The eye has been called "the mirror of the mind". This expression has more meaning to it than what the poet or the romantics may have meant. This particularly so for the Homoeopath, who by his philosophy takes an overall view of all diseases. As such, the condition or ailment of some part of the body that is nearer the surface and visibly and palpably deranged, is not taken as a local disease but as a general disease expressing itself at that place at a particular period of time. Therefore, to the Homoeopath, the eye is not an organ requiring "local" therapeutics. It pertains to one whole: the organism, being irrigated by the same blood, bathed by the same lymph and innervated by the same nervous current.(5)
The selection of the homoeopathic remedy shall therefore depend upon the individual history, features of mind and disposition, objective signs, aetiological factors, concomitant symptoms, characteristic modalities etc.
S.R Wadia, in his book on Homoeopathy in Childrens Diseases, has given a case of post traumatic bilateral LR palsy with squint that was cured with Causticum.(6)
Apis, Belladonna, Cicuta, Cina, Cyclamen, Causticum, Gelsemium, Jaborandi , Natrum mur , Natrum salicylicum, Santonine, Stramonium, Zincum met are some of the homoeopathic medicines that are recommended for LR palsy in homoeopathic materia medica.(7,8)
Case report Master F, 10 years old, was brought for consultation for squinting in both the eyes, which was more marked in the left eye. While looking straight, left eye was seen getting deviated towards nose. The child complained of having double vision, which reducedby tilting the head to one side. Complaint was first noted by the parents about two months back, soon after the child was rebuked harshly by his father for watching his favorite cartoon show and holding the remote with him so that nobody could change the channel. After father snatched the remote control from the child, he became very angry and started crying. Squinting was first seen within a few days of this episode. Parents waited for few days for the complaint to get resolved spontaneously but as that did not happen they took him to an ophthalmologist who diagnosed him with bilateral LR palsy. The parents also reported that his squint was much more visible whenever the child was angry.
Past illness Chicken Pox at the age of 4 years.
Family history Hypertension (paternal and maternal side); Diabetes mellitus (maternal side)
Date Observation Prescription 07.06.2013 Squinting of both eyes, more with Left eye. Tilting of head to one side while looking. Staphysagria 1M/1Dose PL for 3 weeks 26.06.2013 Seems a bit improved Placebo 20.07.2013 Visible improvement in the condition Placebo 01.08.2013 Marked improvement noted Placebo 04.09.2013 Improvement seems status quo Staphysagria 1M/1dose 05.11.2013 Generally better.(An MRI conducted showed no detectable pathology) Placebo 02.01.2014 No squinting is noted. No head tilt. Placebo.
Picture (At the time of first consultation) Dated 07.06.2013 Picture Dated 02.01.2014
Discussion & conclusion Canadian Journal of ophthalmology had published two case studies where emotional factors have acted as aggravating/ triggering factor in cases of strabismus.(9,10)
In this case too, we found such an aetiological/ triggering factor. The squint developed in the child right after the episode at home. Further, parents repeatedly stressed that squinting was worse whenever the child would be angry. Taking this as a characteristic feature of the case, the rubrics Anger, ailments after, with indignation & Anger, suppressed from were referred to, for the case, in Kents Repertory.(11)
The other characteristic features of the case were: 1. Highly sensitive and irritable patient. (12,13,14) 2. Chilly patient.(15,16) 3. Strong desire for stimulating drinks. (17)
The remedy was found mentioned prominently in the rubrics and also covered the other characteristic features. However, Staphysagria was not mentioned under the rubric Strabismus in Kents Repertory. Since the remedy covered the generalities of the patient besides the triggering/ modifying factor it was prescribed to the child. Also the emotional causation and effect in eye warranted the prescription of high potency, hence 1M potency was selected.
The improvement in the case highlights the efficacy of homoeopathy in both ophthalmological and neurological diseases. It shall be wise to remember the words of late Dr Pierre Schimdt, who said, Local diseases do not exist, but solely localised, morbid affections are to be found.
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Edition 1990; pp272 15. Kent JT. Repertory of Homoeopathic Materia Medica. B.Jain Publishers Pvt. Ltd, New Delhi. Sixth Edition 1994; pp xxx 16. Boericke W. Pocket Manual of Homoeopathic Materia Medica & Repertory. B. Jain Publishers Pvt. Limited, New Delhi. 9 th Edition 1992; pp 608 17. Boericke W. Pocket Manual of Homoeopathic Materia Medica & Repertory. B. Jain Publishers Pvt. Limited, New Delhi. 9 th Edition 1992; pp 607