A Case Of Sleep Disorder
Successfully treated by - Dr.Sunil Sharma D.H.M.S , D.I Hom (London) , M.D
Ex-Vice Principal S.P.H Hom. Medical College , Chhatarpur(M.P)
Member- Asian Medical League, H.M.A.I
Author- Guide To Repertory
Master S , 16 years old, from a village near distt.Chhatarpur(M.P) ,he was accompanied by his uncle. His parents worked in a utensil factory in some other town. He had sudden fainting episodes of short duration ,about a minute of two. Complaints,as told by him - 1.Sudden fainting attack , only for a short duration of time 2.Exhaustion on least exertion. 3.Sudden awaking from sleep, often accompanied by screaming. Such episodes occurred twice or thrice in a month. Soreness in the whole body on day after the episode.
During the conversation , the boy answered very promptly and his memory seemed extremely acute. As per him he fainted all of sudden for the first time when he was in his classroom. He could not afford the cost of treatment so he took no medication for the same. The next episode followed some 15 days after the first. Also he used to shout all of sudden while in sleep after certain dreams which he could never remember, which could awaken him and after that he could not sleep at all and with soreness in the body next day. Least physical work even ascending stairs could exhaust him to an extent that he had to rest for a couple of minutes to proceed for some other job. His uncle told that he is very friendly and jolly natured guy.
PAST HISTORY –Nither the boy nor his uncle had a clue about the Intrauterine history, dentition & other milestones and as per the boy there was no illness, injury or accident in past.
FAMILY HISTORY –Nothing Significant
PHYSICAL GENERALS-
He had good appetite, about four meals a day.No specific desire , aversion or intolerance to any food item. Thirst- decreased ,barely a glass or two even in summers.Bowel habit was regular. Stools; semisolid, soft , satisfactory, once daily. Urine ; clear ,transparent (D-3-4,N-1-2).
Tongue – clear, moist. No trembling.
GENERAL PHYSICAL EXAMINATION
Fully conscious with perfect orientation of time and space
Built – mesomorphic. Wheatish.
Pulse – 80/min; regular ; full. B.P – 120/90mm Hg
The forehead was warm , and the nose was less warm as compared to forehead.
SYSTEMIC EXAMINATION
NAD. The cranial nerve reflexes – normal.
INVESTIGATIONS-There was a need of investigations ( CBC , ESR , ELECTROENCEPHALOGRAPHY or PET ) but the person could not afford the same at all.
Arnica Montana 1m single dose followed by S/L four pills thrice daily for fifteen days.
The boy came after a fortnight,He had an episode of screaming at night once and fainting episode twice in these fifteen days. But this time he felt very less soreness in body after the episode .But there was exhaustion on slight exertion. On Examination,nose colder as compared to the forehead , but this time the difference of temperatures was lesser. He complained of dry skin of whole body.
Another dose of Arnica Montana 1M , followed by S/L six pills three times a day for fifteen days.
MANAGEMENT & ADVICE: (1). I adviced him for the change of soap, as he had been using the soap for washing clothes on his body which made his skin dry.
After next fifteen days, He had no episode of screaming at night and one attack of fainting.He himself said that he is much better now and there is no sore feeling in the body.But he felt exhausted on slight exertion.On examination , there was much lesser temperature difference of nose and forehead. Another dose of Arnica Montana 1M , followed by S/l six pills three times a day for fiftenn days.
The boy called me up after a week , he said he has fever and running nose after eating plentiful of icecream and sweets in a wedding,two days back.There was profuse ,watery discharge from the nose and feverish feeling,loss of appetite,could not appreciate the taste of food, along with extreme prostration and thirst. As he could not come to my clinic and I was also unaware of the route of that interior village so that I could visit him personally, I asked him to send his uncle to collect medicine.The possibilities were-1.Indisposition , of course And 2.(?) Flu
Arsenic Album 30 ,four pills thrice daily for three days.Rest other medicine to be continued.
ADVICE & MANAGEMENT- 1.To take rest, 2.Avoid oily or rich food,curd,coloured sweets , 3.Eat green leafy vegetables like spinach etc.
I asked him to report me after two days.
He called me up after five days.He had no fever and no running nose but appetite was decreased and exhausted feeling was there since he had the cold and fever.There had been no attack of fainting or screaming.
I adviced him to continue the medicine and try to eat in small amount but in increased frequency,five to six times a day, even if he had no desire to eat ,I said u eat just half chapati with some green vegeatble at a time, and in same way take small amount of food atleast in every three to four hours and drink plenty of water.
In his next visit, he said he had no fainting episode , no screaming episode and no soreness.Appetite was now restored as it was initially,before the cold. On Examination , there was very less temperature difference between nose and forehead. Exhaustion was much less as compared to the previous state.
Arnica Montana 1m one dose and S/L six pills ,thrice daily were prescribed for fifteen days
This time he came absolutely relaxed and there was a calm expression on his face.He had sound sleep with no exhaustion , no screaming attack and no fainting episode.The temperature difference between nose and forehead was almost neggligible. S/L ,six pills thrice daily for a month.
ADVICE AND MANAGEMENT- 1.Avoid overexertion 2.To report through phone in case he feels anykind of trouble.
3.Eat green leafy vegetables and avoid seasoned food.
CRITERIA OF PRESCRIPTION-
MATERIA MEDICA PURA –
The chronological development of symptoms helps us to identify and then prescribe according to the staging of disease. This is the late appearing symptom in the proving record of Arnica Montana in the Materia Medica Pura.
SYMPTOM NUMBER 570 –
VIVID DREAMS TOWARDS MORNING , IN WHICH HE TALKS ALOUD, SO AS TO AWAKE HIMSELF. ( 6th d.) [ Kr.]
REFERENCE FROM REPERTORIES -
Repertory Of The Homoeopathic Meteria Medica - J.T Kent
Chapter : Sleep
Rubric – Dreams ,vivid : Arn (Italics)
Rubric- Waking,
Subrubric –dreams from : Arn (Italics)
Boger – Boenninghausen’s Characterstic Repertory
Chapter : Dreams
Rubric – vivid : Arn (Bold)
Chapter : Sleep
Rubric – during sleep
Subrubric – talking : Arn (Italics)
Subrubric – screaming out ,shouting,shrieking : Arn
Rubric – Waking
Subrubric – dreams by : Arn
Repertory Of The Hering’s Guiding Symptoms – Calvin Brobst Knerr
Chapter : Sleep
During sleep , screaming :
loud crying out in meningitis infantum $ Arn
(symptom verified by cures)
REFERENCE FROM PRACTICE OF MEDICINE -
Tonic Clonic Seizures – It has five phases viz. Premonitory , Immediate Pre-Tonic Clonic Phase , Tonic ,Clonic , Postictal.
In Postictal Phase – “Confusion is invariable in this phase , and the patient often lapses into deep sleep. Patients may awaken minutes or hours later with generalized headache and muscle soreness.”
2.Temporal Lobe Epilepsies – Lateral (neocortical) temporal lobe seizures are characterized by auditory hallucinations or illusions or dreamy state , visual misperceptions or language disorders in case of language dominant hemisphere focus , and more prominent motor activity than mesial temporal seizures . However , rapid spread often produces features similar to mesial temporal seizures.
3. Sleep Disorders - Dreaming is a characterstic feature of REM Sleep . The dreams are vivid , active and filled with colourful and complex ideation.
Other Manifestations Of REM Sleep - Abnormality in Narcolepsy/ Catalepsy
syndrome include Sleep Paralysis and Hypnagogic hallucinations.
Hypnagogic Hallucinations – These are vivid dream like images which the narcoleptic patient experiences during sleep onset or immediately on waking up,screams,shouts or mutters . Night-time sleep is usually associated with frequent awakening and excessive body movements.
Successfully treated by - Dr.Sunil Sharma D.H.M.S , D.I Hom (London) , M.D
Ex-Vice Principal S.P.H Hom. Medical College , Chhatarpur(M.P)
Member- Asian Medical League, H.M.A.I
Author- Guide To Repertory
Master S , 16 years old, from a village near distt.Chhatarpur(M.P) ,he was accompanied by his uncle. His parents worked in a utensil factory in some other town. He had sudden fainting episodes of short duration ,about a minute of two. Complaints,as told by him - 1.Sudden fainting attack , only for a short duration of time 2.Exhaustion on least exertion. 3.Sudden awaking from sleep, often accompanied by screaming. Such episodes occurred twice or thrice in a month. Soreness in the whole body on day after the episode.
During the conversation , the boy answered very promptly and his memory seemed extremely acute. As per him he fainted all of sudden for the first time when he was in his classroom. He could not afford the cost of treatment so he took no medication for the same. The next episode followed some 15 days after the first. Also he used to shout all of sudden while in sleep after certain dreams which he could never remember, which could awaken him and after that he could not sleep at all and with soreness in the body next day. Least physical work even ascending stairs could exhaust him to an extent that he had to rest for a couple of minutes to proceed for some other job. His uncle told that he is very friendly and jolly natured guy.
PAST HISTORY –Nither the boy nor his uncle had a clue about the Intrauterine history, dentition & other milestones and as per the boy there was no illness, injury or accident in past.
FAMILY HISTORY –Nothing Significant
PHYSICAL GENERALS-
He had good appetite, about four meals a day.No specific desire , aversion or intolerance to any food item. Thirst- decreased ,barely a glass or two even in summers.Bowel habit was regular. Stools; semisolid, soft , satisfactory, once daily. Urine ; clear ,transparent (D-3-4,N-1-2).
Tongue – clear, moist. No trembling.
GENERAL PHYSICAL EXAMINATION
Fully conscious with perfect orientation of time and space
Built – mesomorphic. Wheatish.
Pulse – 80/min; regular ; full. B.P – 120/90mm Hg
The forehead was warm , and the nose was less warm as compared to forehead.
SYSTEMIC EXAMINATION
NAD. The cranial nerve reflexes – normal.
INVESTIGATIONS-There was a need of investigations ( CBC , ESR , ELECTROENCEPHALOGRAPHY or PET ) but the person could not afford the same at all.
Arnica Montana 1m single dose followed by S/L four pills thrice daily for fifteen days.
The boy came after a fortnight,He had an episode of screaming at night once and fainting episode twice in these fifteen days. But this time he felt very less soreness in body after the episode .But there was exhaustion on slight exertion. On Examination,nose colder as compared to the forehead , but this time the difference of temperatures was lesser. He complained of dry skin of whole body.
Another dose of Arnica Montana 1M , followed by S/L six pills three times a day for fifteen days.
MANAGEMENT & ADVICE: (1). I adviced him for the change of soap, as he had been using the soap for washing clothes on his body which made his skin dry.
After next fifteen days, He had no episode of screaming at night and one attack of fainting.He himself said that he is much better now and there is no sore feeling in the body.But he felt exhausted on slight exertion.On examination , there was much lesser temperature difference of nose and forehead. Another dose of Arnica Montana 1M , followed by S/l six pills three times a day for fiftenn days.
The boy called me up after a week , he said he has fever and running nose after eating plentiful of icecream and sweets in a wedding,two days back.There was profuse ,watery discharge from the nose and feverish feeling,loss of appetite,could not appreciate the taste of food, along with extreme prostration and thirst. As he could not come to my clinic and I was also unaware of the route of that interior village so that I could visit him personally, I asked him to send his uncle to collect medicine.The possibilities were-1.Indisposition , of course And 2.(?) Flu
Arsenic Album 30 ,four pills thrice daily for three days.Rest other medicine to be continued.
ADVICE & MANAGEMENT- 1.To take rest, 2.Avoid oily or rich food,curd,coloured sweets , 3.Eat green leafy vegetables like spinach etc.
I asked him to report me after two days.
He called me up after five days.He had no fever and no running nose but appetite was decreased and exhausted feeling was there since he had the cold and fever.There had been no attack of fainting or screaming.
I adviced him to continue the medicine and try to eat in small amount but in increased frequency,five to six times a day, even if he had no desire to eat ,I said u eat just half chapati with some green vegeatble at a time, and in same way take small amount of food atleast in every three to four hours and drink plenty of water.
In his next visit, he said he had no fainting episode , no screaming episode and no soreness.Appetite was now restored as it was initially,before the cold. On Examination , there was very less temperature difference between nose and forehead. Exhaustion was much less as compared to the previous state.
Arnica Montana 1m one dose and S/L six pills ,thrice daily were prescribed for fifteen days
This time he came absolutely relaxed and there was a calm expression on his face.He had sound sleep with no exhaustion , no screaming attack and no fainting episode.The temperature difference between nose and forehead was almost neggligible. S/L ,six pills thrice daily for a month.
ADVICE AND MANAGEMENT- 1.Avoid overexertion 2.To report through phone in case he feels anykind of trouble.
3.Eat green leafy vegetables and avoid seasoned food.
CRITERIA OF PRESCRIPTION-
MATERIA MEDICA PURA –
The chronological development of symptoms helps us to identify and then prescribe according to the staging of disease. This is the late appearing symptom in the proving record of Arnica Montana in the Materia Medica Pura.
SYMPTOM NUMBER 570 –
VIVID DREAMS TOWARDS MORNING , IN WHICH HE TALKS ALOUD, SO AS TO AWAKE HIMSELF. ( 6th d.) [ Kr.]
REFERENCE FROM REPERTORIES -
Repertory Of The Homoeopathic Meteria Medica - J.T Kent
Chapter : Sleep
Rubric – Dreams ,vivid : Arn (Italics)
Rubric- Waking,
Subrubric –dreams from : Arn (Italics)
Boger – Boenninghausen’s Characterstic Repertory
Chapter : Dreams
Rubric – vivid : Arn (Bold)
Chapter : Sleep
Rubric – during sleep
Subrubric – talking : Arn (Italics)
Subrubric – screaming out ,shouting,shrieking : Arn
Rubric – Waking
Subrubric – dreams by : Arn
Repertory Of The Hering’s Guiding Symptoms – Calvin Brobst Knerr
Chapter : Sleep
During sleep , screaming :
loud crying out in meningitis infantum $ Arn
(symptom verified by cures)
REFERENCE FROM PRACTICE OF MEDICINE -
Tonic Clonic Seizures – It has five phases viz. Premonitory , Immediate Pre-Tonic Clonic Phase , Tonic ,Clonic , Postictal.
In Postictal Phase – “Confusion is invariable in this phase , and the patient often lapses into deep sleep. Patients may awaken minutes or hours later with generalized headache and muscle soreness.”
2.Temporal Lobe Epilepsies – Lateral (neocortical) temporal lobe seizures are characterized by auditory hallucinations or illusions or dreamy state , visual misperceptions or language disorders in case of language dominant hemisphere focus , and more prominent motor activity than mesial temporal seizures . However , rapid spread often produces features similar to mesial temporal seizures.
3. Sleep Disorders - Dreaming is a characterstic feature of REM Sleep . The dreams are vivid , active and filled with colourful and complex ideation.
Other Manifestations Of REM Sleep - Abnormality in Narcolepsy/ Catalepsy
syndrome include Sleep Paralysis and Hypnagogic hallucinations.
Hypnagogic Hallucinations – These are vivid dream like images which the narcoleptic patient experiences during sleep onset or immediately on waking up,screams,shouts or mutters . Night-time sleep is usually associated with frequent awakening and excessive body movements.
