A CASE OF DUCHENNE MUSCULAR DYSTROPHY

A very affectionate child, 4.5years, a case of Duchenne Muscular Dystrophy, came to me on 16 Feb 2010, with tremendous weakness in muscles of upper & lower limbs with hypertrophy.
Due to weakness in the limbs, child wants to be carried after walking for little distance, very sensitive to pain. He is not able to climb up & downstairs otherwise he requires support.
His CPK enzyme levels were 33616 IU/L on 16/09/09. (Normal levels are 25-192 IU/L).

He was on Prednisolone 40mg/day on tapering dose since 6 months to 10mg/day without any improvement in the weakness. In fact his muscle weakness is increased.
He is having flat foots.

Nature wise, very affectionate; restless; shy; likes to play in company; does not like to go to school; when questioned, he becomes dull, unable to answer either due to timidity or difficulty on thinking; getting irritable on very small matters; fears dark; with active memory; found to be disobedient, biting his nails & putting the fingers in mouth, continuously moving here & there in the consulting room.
His mother told that he is homesick, moody child but desires to travel a lot.
He eats pencil a lot. He sleeps on abdomen. He still wets his bed at night.

Past History:
Neonatal Jaundice at birth
H/O Partially developed Chickenpox 2 years back

Family History:
Diabetes: PGF & MGF
Hypertension: PGF & MGF
Myocardial Infarction: PGF

Personal History:
Desires: Indigestible things++

Duchenne muscular dystrophy
• Duchenne muscular dystrophy (DMD) is a recessive X-linked form of muscular dystrophy, which results in muscle degeneration, difficulty in walking & breathing, and death.
• The incidence is around 1 in 3,600 boys.
• Females and males are affected, though females are rarely affected and are more often carriers.
• The disorder is caused by a mutation in the dystrophin gene, located in humans on the X chromosome (Xp21).
• The dystrophin gene codes for the protein dystrophin, an important structural component within muscle tissue.
• Dystrophin provides structural stability to the dystroglycan complex (DGC), located on the cell membrane.
• Symptoms usually appear in male children before age 5 and may be visible in early infancy. Progressive proximal muscle weakness of the legs and pelvis associated with a loss of muscle mass is observed first. Eventually this weakness spreads to the arms, neck, and other areas.
• Early signs may include pseudohypertrophy (enlargement of calf and deltoid muscles), low endurance, and difficulties in standing unaided or inability to ascend staircases.
• As the condition progresses, muscle tissue experiences wasting and is eventually replaced by fat and fibrotic tissue (fibrosis).
• By age 10, braces may be required to aid in walking but most patients are wheelchair dependent by age 12.
• Later symptoms may include abnormal bone development that lead to skeletal deformities, including curvature of the spine. Due to progressive deterioration of muscle, loss of movement occurs, eventually leading to paralysis.
• The average life expectancy for patients afflicted with DMD is around 25, but this varies from individual to individual.
Pathogenesis of DMD
• Dystrophin is responsible for connecting the cytoskeleton of each muscle fiber to the underlying basal lamina (extracellular matrix) through a protein complex containing many subunits.
• The absence of dystrophin permits excess calcium to penetrate the sarcolemma (cell membrane). Alterations in these signaling pathways cause water to enter into the mitochondria which then burst.
• Muscle fibers undergo necrosis and are ultimately replaced with adipose and connective tissue.


MIASM
SYCO-TUBERCULO-SYPHILITIC

RUBRICS SELECTED
1. Affectionate
2. Sensitive , oversensitive, Pain to
3. Extremities, Weakness, Upper limb
4. Extremities, Weakness, Lower limb
5. Restlessness, Children, in
6. Timidity
7. Company, desire for
8. Aversion, School, to
9. Dullness, Children, in
10. Irritability, Children, in
11. Fear, Dark
12. Memory, Active
13. Disobedience
14. Biting, Nails
15. Mouth, Fingers in mouth, Children put
16. Homesickness
17. Mood, Changeable, variable
18. Travel, Desire to
19. 19. Generalities, Food, Indigestible things, Desire
20. 20. Sleep, Position, Abdomen, on
21. 21. Bladder, Urination, Involuntary, Night, incontinence in bed

Result of Repertorisation:

Calc phos: 32/21

Calc carb: 31/18

Lyco: 33/17

Sil: 32/17

Sulph: 25/16



Remedy Prescribed
Calc Phos 6x tds for 10 days
Prednisolone stopped by the patient’s parents a week back as there was no relief.

Follow Up (26/02/10)
He suffered from Mumps on right side on 20th Feb & recovered itself within 4 days without any medicine.
Playing with friends, weakness decreased a lot after the mumps.
Remedy continued in bd doses for 15 days.

I already advised them that he might suffer from any infectious disease after starting the treatment based on understanding from Predictive Homoeopathy. So, if anything happens, please, don’t give any medicine. (Ref: Verbatim by Dr Praful Vijaykar, Chapter 14)

• Why the Mumps did came up? Is it a good or bad sign?
• Mumps is a tumor virus like HSV, EBV & CMV.
• Why are they known as tumor virus in the allopathic world? Because when they infect & go to the cell, they cause a change in mitotic cycle in such a manner that extra growth occurs in a cell. The cell starts growing excessively giving rise to tumors. For us it is a Sycotic virus.
• Therefore, sycotic virus being thrown out of the body is a good sign in this case. The tumor viruses when thrown out to clear the internal malady or dysfunction are exteriorization....
• ...So, just rejoice & lay your hands off if tumor virus appears. The virus is in the neuro-ectoderm & is thrown off. This is a excellent sign. These viruses, especially tumor virus harboring in the nerves or muscles are thrown off through the prochordal plate. So the patient will first get some throat problem & then on the body.
• Tumor viruses being exteriorized is one of the best result for the Homoeopath.
• (Ref: Verbatim by Dr Praful Vijaykar, Chapter 14)


Follow Up (12/03/10)
Weakness in limbs much decreased.
He started running as well as climbing staircase without support.
He was getting thick nasal discharge since week with occasional dry cough.
His confidence level increased.
Remedy continued in od dose for 1 month.

Follow Up (12/04/10)
He is walking without asking for carrying. He is playing cricket, running here & there, climbing up & down stairs without any support. Now he is found as very happy looking child.
Remedy continued in od dose till 19/01/11 when his CPK enzyme levels were measured & found to be 1075 IU/L.

Follow Up (19/01/11)
His weakness in the limbs was absent.
His bed wetting also stopped.
He complained of Pain in his knees while squatting.
Otherwise, he is playing, running, climbing up, & downstairs without any support.
Remedy Prescribed: Calc Phos 30 3 doses followed by Placebo daily.

Recent Follow Up (20/10/11)
Weakness in the limbs absent.
No bed wetting.
Pain in his knees while squatting was absent.
He is playing, running, climbing up & downstairs without any support enjoying his life.
He is on Placebo.

DR.PRASAD RASAL HMD(London), MD(Hom)
Sai Swami Computerized Homoeopathic Clinic, Hospital, Research Center & Maternity Home
Indiranagar Lane No.1, SANAGMNER 422605
DIST: AHMEDNAGAR.
PHONE: (02425) 223913.
MOBILE: +91 9890168872.
Email: drprasadrasal@rediffmail.com.
Blog: www.drprasadrasal.blogspot.com
Website: www.dynamichomoeopathy.in