A Case of Myoclonic Jerks and Schizophrenia

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A Case of Myoclonic Jerks and Schizophrenia

Abstract: A case of a delusional paranoid schizophrenic, with a history of past hospitalization and multiple psychotropic drugs, who responded favorably to homeopathy is presented. This young woman, after a four year follow-up without relapse, is off all allopathic medications and currently leads a productive life as a school teacher. Her remedy of cure, Lilium tigrinum, is a smaller remedy. Its selection places emphasis on the need for persistence when obvious better known remedies fail to achieve lasting curative results.

Keywords: Lilium tigrinum, Kali bromatum, Cannabis indica, delusions of devils, schizophrenia.

I first treated K.J., a 28 year-old female, on 3/11/94. I was a relatively new graduate of the Hahnemann College of Homeopathy in Berkeley, California, and because of my excellent education and the relative success I had been having with classical homeopathy treating organic pathology, I thought very little of the consequences of treating K.J. after taking her case. In fact, visions of a brilliant cure, based on the exceptional key notes, raced through my mind as I took and videotaped her case.

I have since treated many patients with deep psychiatric illness and have learned some admittedly hard and painful lessons that I would like to share from the onset, before presenting this rather unusual case.

Firstly, in delusional patients who have lost touch with reality and have such a distorted view that they are in constant terror and may do damage to themselves or others, don't be inflexible about how they should be treated. If allopathic medicine is controlling their symptoms, even with some side effects, be grateful. You can still begin treatment, but cautiously and certainly without taking them off of their allopathic medicines.

Secondly, under no circumstances should you discontinue psychotropic or active allopathic medications. If you do, despite your brilliant homeopathic prescriptions, the patient is very likely to end up institutionalized, especially if there is already a history of psychology ward admissions.

Thirdly, work with the psychologist or psychiatrist on the case and Let him take the patient off drugs, very slowly, tapering down once clinical improvement sets in.

Fourthly, don't give up, and if the big obvious remedies don't work, look deeper, especially for smaller remedies.

Fifthly, short-term improvement doesn't mean you are home free; small things or personal events can upset these patients very easily and either override the remedy or in some way undo the good you thought had been done. This usually means you didn't get the exact similimum.

Sixthly, suicidal patients are just that, suicidal. If you are not prepared to deal with that, make sure someone on the health care team, preferably the patient's psychiatrist is available and cooperative, otherwise beware!

Now with that preamble complete, I feel comfortable in presenting this case. I have four years' follow-up, and this patient is now off of all medications and fully functional as a school teacher. She comes by the office from time to time to make payments on her bill and get an occasional remedy. So here is the case:

3/11/94

K.J was brought into the office for an emergency initial visit. She presented as a 28 year-old Caucasian female. I observed her to be tall, about 5'10," and of large stature, although not obese -- a pretty girl with a soft face, clear white skin, black hair and dark eyes, well dressed in skirt and sweater. She wore lip stick, light makeup, and sparse jewelry. She appeared obviously distracted and distressed, with a sullen look. There were large bags under her eyes.

She began: "I feel like I'm falling during the day. Falling forward or backward. My chair seems to be swinging, rolling from side to side. My legs feel like they are moving, yet they aren't. My legs and arms suddenly jerk out.

"I had a crises Tuesday and I thought I would kill myself. I was going to stab myself or hang myself with a rope. Hang myself! I have great anxiety. I am very shaky! I am panicked, full of panic!

"I went to a hospital emergency room and was given Buspar and Anafranil and chlorhydrate.

"The earth feels like there is an earth quake! My eyes are shaking and weird ever since. I think a lot of thoughts; I'm obsessive. I've got to talk to a certain person. I'm desperate; I've been crying."

I observed, as she spoke about having to talk to some person, that she was very anxious, irritated and crying. It wasn't, however, an hysterical cry, but more of a beseeching cry.

She continued: "At one time I was almost well when I was seeing doctor with a special homeopathy machine, a Voll machine. Since 1993 I have been seeing this doctor. He gave me medicines that I think have now made me worse. I am much worse. I am shaking inside, shuttering inside, violently shaking inside."

She paused then began: "I have never been well since I went on a diet of amino acids and vitamin B. It's weird; two days after the diet my symptoms started, in 1993.

"I graduated from college in May 1992. Then I got sick on the job with this illness. I was a director of a juvenile delinquent program."

The intensity of her speech increased as she continued, "The devil is coming out. He has big eyes -- a double-headed demon. I didn't say anything. I prayed a lot.

"When the devil came, there were no voices. I was praying. I had a powerful experience of God. The demon went away.

"My past treatments included prayer, stellazine, Mellaril, tricyclic antidepressants, and psychiatric ward hospitalization.

"I have been depressed for over one year, and it won't go away! It won't go away," she lamented with tears and passion. "I'm fatigued. I have no one! I don't want to die," she exclaimed, crying.

"I came from a dysfunctional family. I had a career after school doing child care. I've been studying for the national teachers exam. I've slept eight hours during the past six days. Every time I go to sleep, I get a startle response which wakes me. It scares me!

"The psych ward helped; Clonopin for four months helped. I hallucinate about spiders. I get wired with medicines, a paradoxical response.

"I have a past history with my mom's boy friend; he kissed me at age six, then a French kiss at age 10. My uncle played with my breasts. Mom slapped me around.

"I'm sloppy. I awake feeling somebody is in the room. As a child, I felt that someone was in the closet. I fear failure. I have anxiety and fear and can't focus. I love water, and the ocean. I'm OK with spiders. I don't like dogs, but I do like cats.

"The 1989 earthquake scared me to death," she said with force and emotion. "I was stunned. I'm OK on bridges. I don't like to sleep without lights on. The lights help me feel I'm not alone.

"I'm a recovering drug addict -- methamphetamine, Dexedrine, snort crystal, pot from ages twelve to twenty-four. I did `black beauties.' I've been clean for four years. I have done AA, Alanon, and a twelve-step program. I have the church.

"I'm a slow starter in morning. It takes two to three hours for my energy to get going. I have trouble sleeping at night. I stay up till two a.m.; I used to stay up all night. I'm not a party person. Very introverted. Very little sexual experience. I bite my nails, pick at them.

"I had bronchitis as a child, and at age three was hospitalized and almost died with kidney disease. I had delirium at age three. I've had no physical trauma, no surgery. I recently had strep throat and was on erythromycin two weeks ago. I have mild psoriasis.

"My PMS is terrible! As soon as I ovulate. As soon as my period starts or after it starts the PMS is gone. After the flow everything is OK. I'm connected to the universe. I cry with joy for three days.

"During my period if I get angry, I'm much worse. Anger sets me off. I become violent. During my periods I see people who aren't there. They're not there. They look real. They are shadowy shapes.

"I feel chosen, feel chosen.

"A boy died; he was nine, and shot by a gun. He died October '93. He is saved!

"My pastor at the church said there are demons. There are levels of demonisation. I saw the movie "The Exorcist" twelve times. I have watched too many scary movies. I've read books on demons and Satan, Jungian psychology. A psychic predicted my illness.

She continued: "My seizures are intense. I am shaken awake. They are intense. I have myotonic shakes that are intense. Very intense," she stressed.

"My father was an alcoholic.

"I do lots of praying with lots of crying"

I asked her about foods, and she replied, "I crave Chinese (3), chocolate (1), coffee (2), sweets (1), green fruit. I'm very thirsty, but not for really cold drinks. Cold hurts my teeth."

She slept on her back or sides, never on her abdomen. Her body temperature was cool. She liked to be warm, with lots of blankets.

A dog bit her when she was a little girl, but not badly.

She said, "My friend is into black magic; she made a death curse! I played with my genitals as a kid in my bed room. I fear devils."

Analysis

Religious delusions play a central role in this case. The following remedies invite comparison.

Kali Bromatum : Details of the case which suggest this remedy include issues with devils, the occult, exorcism, the priest; the intensity of her complaints; the appearance of watery bags under her eyes; the issue of praying, beseeching; the polarity of conservatism, aligning with the church, her conservative appearance, yet her interest in the occult. She was involved in the church and exorcisms, ritualistic behavior. She felt singled out by the devil, cursed and forsaken. She saw the dead during her periods. This perhaps suggests an hormonal remedy with mania. We shall see.

Mancinella: Fear of devils, psoriasis, fear of insanity. Of course, there is the well-known etiology of mania after seeing too many scary or occult movies -- never well since a scary movie. Fear yet fascination in the devil and the occult.

Lachesis: We automatically, perhaps too quickly, think of Lachesis because of the symptom worse before the menses, better with onset of the flow. Lachesis has the intensity, the violence, the passion, the mania with hormonal changes.Lachesis is usually hot or at least warm; this patient was on the chilly side. Lachesis is usually more flamboyant; this young lady, however, was conservative, more like a Kali. Lachesis, of course, can talk to the dead with mania during periods. She was not worse from tight clothing around the neck, as I recall.

Stramonium: The intensity of the symptoms, and never being well since an earthquake (Aconitum) point to Stramonium. The etiology of sexual abuse also points to this remedy. Stramonium is a prevalent female rage remedy with a past history of abuse, all too common in our questionably civilized society. The issues of mania, visions of devils, and despair of being deserted are all consistent with this remedy.

Veratrum album: Points for Veratrum include delusional talking to God or the dead; the feeling of being special or chosen; the delusion of talking to God; praying; mania.

Thuja: For this remedy there is the separation of two bodies, spiritual and psychic; the out of the body experience. (Anacardium has similar themes.)

Argentum nitricum: The forsaken feeling.

Cannabis indica: Points for Cannabis are the drug abuse, the visions, the feeling of being deserted, the internal shakiness and shock. She had a good sex drive but no partner, and she complained of a terribly itchy urethra after the case had been taken. (cann-i, acon)

Rx: Cannabis indica 10M

Follow-up: 3/14/94

Her sleep was better. I observe that her eyes looked better, with no bags. She looked more alive.

She began: "I'm sleeping better. I have less startle response. I still have panic and terror. I use cognitive behavior; I don't work with terror. I think my way through the terror. I have low blood sugar. I'm not that thirsty. My urethral itchiness gone.!

Rx: Wait

3/28/94

She arrived talking very rapidly. There was more color in her face while looking in the mirror; however, she felt everything about her was ugly, every wrinkle. She had fear at night and complained of a sensation of falling backward.

"Jerks wake me up -- violent jerks. My PMS is better with the flow, but not the first drop as before. I have anxiety, and everything bothers me. I can't stand hair on my face. I get pissed off at the drop of a hat. I feel jealous, suspicious, and fearful. I feel an impulse to kill myself, just before the flow. I have internal shame.

"I must talk with my pastor. I panic.

"My period starts, then two hours later I am connected to the universe; by the third day I'm back to my old self -- clumsy, forgetful, high energy, with nine projects at once.

"With the panic I feel I can't breathe. I have panic disorder; I can't breathe. I feel terror. I imagine the pastor will help me. I panic and don't know what to do. I'm desperate. Desperate!

"I feel terror with nowhere to run. I feel the bed moving. I'm scared. I wake after two hours. I begin bargaining with God. I'm confused with God. Angry. I feel like smashing things. I am in the army of the church, the army of God. I'm gripped with fear. I was left alone when a kid. Jesus disarmed me publicly. The devil rebuked me in the name of Jesus. My pastor and sister enter my mind, demonic figures too, and my dead father comes. My father comes almost into my room; someone picks up my bed and shakes it. I'm praying constantly, to God for salvation. It's like an earthquake in my body. Demons will take me. I talk to God."

Rx: Kali bromatum 200C, wait five minutes then 1M. Kali-brom. 30C, h.s., p.r.n. sleep or terror.

Phone call - 3/31/94: "I'm much better, sleeping better, remembering my southern Baptist background, devils and hell and punishment. I am doing things Baptist people do. My psoriasis is better."

4/4/94

She began: "Insomnia. I can't sleep; I fall asleep, then awake two hours later. I have a startle response. Fear, and I cry out.

"My PMS is better. The ministry team is helping. They did an exorcism at church. I look across doors. I have a fear to unlock doors. I make sure all doors and windows are locked; I did this as child and I do it now.

"I feel the presence of God, of good, instead of evil.

"I have been sneezing. I have hayfever, and my nose is running."

Rx: wait

4/29/94

I received an urgent phone call from her mother: "She is crying and hysterical. I will watch her. I don't want her on drugs or in the hospital!"

6/17/94

She is overall better, but still worse around period.

Rx: Kali bromatum 10M

7/11/94

"I'm worse again! I have terrible premenstrual panic, anxiety, and mania. I'm shaking at night; the myoclonic jerks wake me up. It must be hormonal," she insisted emphatically.

Rx: wait

8/30/94

"I'm still not better. I hate God. I'm never going to pray again. God has turned on me."

Rx: Veratrum album 1M

10/3/94

"I'm no better."

At this point I re-analyzed the case: The central theme became clearer: tormented about her salvation. suicidal, rejected by God, fears, weeping, anxious, tremors, violent shaking, pulsations all over her body, all symptoms worse with ovulation; feeling as though insane during PMS; talking to God; going to sleep with surges of anxiety, shaking her with violent tremors that awaken her from sleep; then, oneness with God and with the world for three days after her flow starts; the correlation of symptoms with hormonal flow, the rise and fall of estrogen and progesterone, with first the devil, then God -- the image of the tiger and the lily, the polarity of violence, intensity, raw emotions with overwhelming peace and oneness. Passion in both extremes -- the tiger lily!

Rx: Lilium tigrinum 200C, 12C at bedtime

1/30/95

Much, much better, but lately the fear and devils were starting to come back.

Rx: Lilium tigrinum 1M

1/2/96

She had been almost well until now, but unpleasant symptoms were starting to come back.

Rx: Lilium tigrinum 10 M [Quinn]

11/22/96

Doing great, in school. "I'm a normal person with no problems at all. Sometimes I have trouble around my periods going to sleep."

Rx: Lilium tigrinum 12C p.r.n. at period.

4/97

Doing great. Just stopped by to say hello and pay part of my bill, and get some more Lilium tigrinum 12C, which I occasionally take."

12/97

"I'm teaching school. I have no more problems. Life is going well. I occasionally take Lil-t 12C. I'm slowly paying down my bill."

She brought me a Christmas gift, a book of precious gems with a thank you note for believing in her and never giving up.

American Institute of Homeopathy.

~~~~~~~~

By Steven I. Subotnick

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