A case of unexplained movement disorder

A 68-year-old female consulted with me regarding a chorea, also known as movement disorder, which she has had for the past 15 or more years. She has seen many neurologists over the years and has also been seen at a University movement disorder clinic without any success or explanation. She tested negative for Parkinson's disease, Alzheimers and Huntingtons.

Her arms and hands move involuntarily and almost constantly. She may fling her arms out to the side, sometimes hitting people, she fidgets a lot, taps her fingers a lot, repeatedly slaps her hand down on the sofa or bed, may play with her wedding ring and place her hand under her husband's pillow on the bed rubbing the material, which drives him crazy.

In addition she suffers from dizzyness when going upstairs and when moving her head from a lower to a higher position, such as after looking under the bed. She feels as if she staggers when she gets dizzy with a tendency to fall to the left.

She also has another problem of severe itching along the outside of her right arm, which comes and goes periodically and can last for up to three months when it starts. This has been an issue for about 20 years. It is worse with stress.

How does she feel about the movement disorder?

"It's annoying. It affects other people around me. I get mad with myself. I feel I should be able to control this but it won't let me. I used to be in control, but I'm not any more."

What's it like to be in control?

"It's empowering, to know what you are doing. At the moment I don't know what I'm doing. I don't know what I'm talking about. I feel like I don't have anything worthwhile to say."

"It's the way my Dad treated me, like crap. He was in control. He was very critical, I could not do anything right. I'd come first in my class and was still told I should have gotten better marks. My mother was very nice but controlling in her own way, but my father controlled the whole family. I got out as soon as I could, via marriage."

Tell more about control?

"I did four years in a convent, the only way I could get a highschool diploma. There you were totally controlled."

"I'm a loner. I'm afraid to let people get too close to me because I might get hurt. That has happened. I always wanted people to like me but they didn't."

If she is upset she will go within herself. "If I open up people will turn on me, it comes back to me. I have not cried in 40 years, even when my parents died a few years ago I did not cry." She is averse to consolation and will refuse it.

Food: She likes red meat (2) butter on veggies, potatoes and crackers (3), mushrooms 2), crab (2), espresso with steamed milk and caramel sauce (2)

Averse oysters (3) and 'slim, slithery seafood' (3), eggs only eaten when hardboiled, hates the whites being slimy

Generals: She is worse in the sun. It makes her arm jurt and the bright light can give her a migraine. She will pick her place in the car depending on the postition of the sun to avoid sitting in the light and used to place a towel over the window to block the sun while travelling.

She has some acid reflux at night and occasionally takes medication for it.

Sleep: She can have interrupted sleep, just wake and be wide awake. This was very bad after one of her daughters moved to a different province four years ago with two of her grandchildren. The patient felt really depressed about this loss.

Health history: She has a history of many years of migraines, was finally diagnosed with hydrocephalus and had a third ventriculotomy, meaning that she had the third ventricle, a fluid-filled sac in the brain, removed surgically. That corrected the migraine problem.

She also has a history of constipation for 40 years. Stool will be like rabbit pellets. Takes a laxative every other day. She does not like to use public toilets. Has driven for 1000s of miles to find a clean or acceptable washroom.

Menstrual history: Her periods were terrible with a lot of flooding and terrible pain as well as extremely irregular to the point that with one pregnancy she did not realize she was pregnant until 4.5 months into it. Sometimes the periods would go on for three weeks. She would feel like Jekyll and Hyde emotionally. Whe she was offered a hysterectomy she was delighted. She may have had endometriosis for years.

She has a history of cold sores, but the outbreaks stopped after she quit smoking a few years ago.

She has a history of leg cramps and would wake up screaming from the pain at night. Not for the last ten years or so.

Examination: I examined her neck carefully as I thought the burning sensations in her arm were related to a vertebral misalignment. She had also seen a medical intuitive who thought that the burning was related to a car accident she had in her mid 30s. After I finished the examination she felt the burning pain more, then the next day she had some relief from it, likely because I had loosened up the tissue a bit.

Plan: I felt that the burning sensation in her arm was directly related to the neck issues and referred the patient to a craniosacral practitioner. She has had enormous relief with four treatments, the burning pain has moved up to the shoulder rather than going all the way down the arm. She is very please with the treatment.

Homeopathy: The patient showed an excellent and unusually clear picture of natrum-mur, the homeopathic preparation of sodium chloride, table salt. People with this constitution tend to hold their feelings in. They tend to be averse to consolation and find it difficult to share their feelings. They may have been deeply hurt in their life and never felt safe to open up again after such an incident. They often cannot cry. They may feel sad but cannot cry and express their feelings. They often have problems from the sun, this patient was markedly aggravated from the brightness of the sun and even covered the car window to avoid exposure. Natrrum mur patients often crave or are averse to oysters and other seafood, this patient was very averse to oysters and slimy seafood as well as uncooked eggwhite. Natrum mur can have chorea and vertigo with a tendency to fall to the left, which is exactly what the patient reported.

I suspect that the uncontrolled movements were the result of a suppression of emotion and would improve with this remedy.

I gave her natrum-mur 30 CH two pellets once a day.

Follow-up after one month: Within three days the vertigo and staggering disappeared. Patient reports an improvement in her movement disorder of 30-40% her husband thinks it is 15-20% improved. Considering that this was after only one month of treatment it is a surprisingly good result! The craniosacral treatment may also be helping the movement disorder.

The combination of craniosacral therapy and homeoapthy has been very helpful in this lady and I expect a full recover within six months or less. She had very obvious and clear symptoms homeopathically which indicated a strong constitution and a good prognosis.

Update: Follow up after two months

The itching is reduced to an area between and around the shoulders, but can still be very troublesome at night. Patient may wake around 2-3 am and be up until 4:30 am with the itching. Ice relieves it. Last week it was quite bad, although it definitely does not radiate down the arm as it has.

The vertigo during the day is still gone but she can experience some at night when she wakes. The chorea is about 20% improved, but the improvement has now levelled out.

Assessment:

The patient may benefit from an additional homeopathic remedy to give her relief from the acute bouts of itching at night.

The constitutional remedy has levelled out as would be expected after two months on a 30CH dosage. The dosage needs to be changed to a 200CH.

Plan: Natrum-mur 200CH, one dose as needed, maybe once a week or less often

Hypericum 30CH in water to dip every few minutes for an acute attack of itching at night.

Note: Hypericum is a homeopathic remedy used for nerve damage. As the itching in this woman's case is related to nerve irritation due to problems with the vertrebrae in her neck I'm hoping that it will relieve her itching which is really a kind of nerve pain.

 (To be continued)