A Case of Asperger’s Syndrome

Homeopath Petr Zacharias presents this case of Aserger’s syndrome with insights into his decision making at each step.

First visit: January 13, 2013

A boy (age 3.5 years) has been diagnosed with Asperger’s syndrome. EEG examination revealed a non-functional left cerebral hemisphere. He was carried to term and the birth was spontaneous, physiological and without complications. When he was 4 weeks old, he got his first coryza from which he has never recovered. He would be healthy for 2 – 3 days and then the coryza would come back. When he was 8 months old, he had a rotavirus infection with a fever between 38 – 38.5°C. Since then, he has never had any fever (not even low grade). He gets ill once a month now, regardless of the season. It is usually a coryza with an obstructed nose or laryngitis, but he never has fevers.

Such episodes used to last 14 days and now it is about 7 – 10 days. The course of his acute diseases has changed. Because he gets ill once a month throughout the whole year, regardless of the season, and the illness influences his general development, he suffers from a significant delay in development (walking and speech) (2). He is allergic to pollen and cats and he was diagnosed with an immune disorder. He has taken allopathic and homeopathic remedies for the allergy without apparent effect. The mother spontaneously reported that his most marked symptom is extreme motor restlessness (4). The boy is very hyperactive (3).

He started running very soon and he always fell a lot. The problem with bad coordination of motion has lasted until now (3), e.g., he falls down all of a sudden, hits himself against a door frame, drops things (1) etc. His ability to coordinate motion is very poor. For example, he is not able to eat on his own because his spoon misses the mouth or the food falls off the spoon. When he was younger, he was very irritable and weepy. He kept shrieking constantly and it was not possible to calm him down by any means. He is hyperactive and has an excess of energy (2). He has problems with comprehension and concentration (3). His sleep has been bad since he was born. He wakes 6 – 8 times per night and he is very restless in sleep (2/3).

He clings to his mother (3) to the extent that he does not bear being with anybody else, even with his father. He tends to have outbursts of anger during which he throws things (2). He is very chilly (3). He comes to his parent’s bedroom at night and wants to be covered (3). He is afraid of the dark (2) and noises (2/3). He loves red fruit and everything red, especially tomatoes (3), cherries, raspberries, and strawberries. He is generally much better from music. In the past, he received Tarentula hispanica from an experienced homeopath and he got much better after the remedy, mainly as far as his restlessness and sleep were concerned. However, 2 – 3 months after the administration of Tarentula, his state got worse again and a repetition of the remedy did not have any effect. Then he got Ignatia, which did not have any positive effect and that is why the homeopath brought the boy to our three-year intense training at the Prague College of Classical Homeopathy.

Depth of the disturbance

The disturbance of the central nervous system confirmed by EEG, which revealed a non-functional left hemisphere, is the source of most of the complaints in this case. The nervous system is the most important organ system in the body and it holds the highest position in the hierarchy of bodily organs. The disturbance of the CNS manifests itself on the emotional and mental level. From the medical point of view, the diagnosis is very serious.

Prognosis and level of health

The nature of the complaints, together with the fact that the center of gravity of the case is in the nervous system and on the emotional and mental level are unfavorable for the prognosis. The picture of symptoms does not clearly indicate any homeopathic remedy, and the child does not have acute diseases with high fevers. Both these factors also make the prognosis worse because they point to the fact that the organism is very weak. Although there is no evident occurrence in the case which could be directly connected to the origin of the complaints with certainty, it is highly probable that the rotavirus infection at eight months, which was his last infection with high fever, made the organism weaker and caused the drop down to a lower level of health.

In cases where the development of the complaints is preceded by some event (etiology), the prognosis is often better than in cases where the complaints develop spontaneously without an external provocation. In the same manner, it is unfavorable for the prognosis when we find complaints similar or the same as those from which the boy suffers in the family medical history. If the complaints develop spontaneously, without a triggering cause, the person must have an even stronger tendency (predisposition) to develop the given complaints.

The fact that the organism has not been able to produce high fever during acute states since the infection, is also in favor of this hypothesis, as well as is the fact that after the infection, the acute disease became milder and chronic complaints developed. On the other hand, we have no information suggesting that there have been any psychological or neurological ailments in the family medical history and that makes the prognosis better. The presence of a relatively high fever in the child’s medical history is also a positive factor and it means that before the disturbance fully developed, his level of health was relatively high (B6). Considering the absence of fevers in the last 1 – 2 years, the organism of this boy is currently at the level C7.

Analysis of the case

In each case without exception, it is necessary to ask oneself several questions first and find answers for them. Then we can proceed to a subsequent analysis. Any further steps would only be a choice of random symptoms and their entering into repertorizing software. Which questions are we talking about? First of all, we have to realize what to focus on in each individual case. We are not looking for separated symptoms, but for their individual pattern. The next question is what should ideally happen after the remedy and which direction the symptoms should take after the remedy. What makes the case the most individual? And what symptoms of this child are not common for other children with the same diagnosis? Which are the most peculiar to the case?

In this case, we need to focus primarily on the disturbance of the nervous system, so the ideal scenario is that the remedy will restore functionality of the non-functional hemisphere. This can only be attained if its dysfunction is not caused by mechanical (structural) damage of the brain and the disturbance is merely functional. After the remedy, apart from improvement of motion ability, we should also witness improvement in concentration, restlessness, sleep, and snoring. The organism should regain its former ability to produce acute diseases with high fevers as well. If a high fever occurs after a homeopathic remedy in such cases, it is nearly always followed by significant improvement of chronic problems.

In cases like this one in which we see a lot of symptoms, it is necessary to choose those that make the child individual and different from other children with the same diagnosis, in this case, Asperger’s syndrome. We call the symptoms that most of the children with Asperger’s syndrome have, pathognomonic symptoms (symptoms which are explicable with the given pathology and are common to all people with this diagnosis). These symptoms are the least important ones as far as the selection of a homeopathic remedy is concerned, because they do not represent the individuality of the case. It is not wise to include symptoms like fear of unfamiliar environment, introversion, desire to do things in a certain way, low ability to adapt to changes, aggressiveness, outbursts of anger, clinging to parents, bad comprehension and concentration, etc. in the analysis. Out of these, only the very intense ones constitute an exception. We have to include them in the analysis, despite their general character. They do not individualize the case by their nature, but they do it through their intensity.  On the other hand, there are symptoms unconnected with the Asperger’s syndrome, e.g., chilliness at night. We cannot say that everybody with the same diagnosis will have this symptom and neither can it be explained by the clinical diagnosis. These symptoms make the case the most individual.

Intense symptoms

  1. motor restlessness
  2. restless sleep
  3. fear of noises
  4. delayed development
  5. desire for tomatoes
  6. bad coordination of lower limbs
  7. awkward hands with dropping things
  8. excessive dependency on the mother
  9. difficult concentration
  10. difficult comprehension

Peculiar symptoms

  1. chilliness at night
  2. general amelioration from music
  3. he loves the color red and everything red

Repertorization in RADAR with Synthesis 9.1 repertory

The repertorization has been made using the technique of summary of symptoms with consideration of their intensity (For Radar users: Sum of symptoms and degrees – intensity is considered)

112344 MIND – RESTLESSNESS – children, in41
212343MIND – RESTLESSNESS – bed – tossing about in172
312343MIND – FEAR – noise, from41
412342GENERALS – DEVELOPMENT – arrested27
512342GENERALS – FOOD and DRINKS – tomatoes – desire3
612343EXTREMITIES – AWKWARDNESS – Lower limbs14
712341EXTREMITIES – AWKWARDNESS – Hands – drops things26
812343MIND – CLINGING – children; in – mother; child clings to the6
912342MIND – CONCENTRATION – difficult300
1012342MIND – DULLNESS – children, in30
1112343CHILL – CHILLINESS – night24
1212343MIND – MUSIC – amel.22
1312342MIND – COLORS – red – desire for5

 

caust.sil.acon.tarent.lyc.merc.bar-c.sulph.calc.bufo
52494646444140403938
13113121
22133221221
32111211
4121221
5
6321
712
811
93321323221
1012213321
1111
12311
131

Differential diagnosis

Causticum can be confirmed on the basis of problems with motor coordination and also delayed development which is a keynote of this remedy. Causticum is also stated in the corresponding rubric for restless sleep, but Causticum restlessness mainly concerns legs in the evening in bed. Strong motor restlessness is the leading symptom of the case and it is not a keynote of Causticum, and neither is the strong emotional dependency. It is interesting that Causticum can be found in the rubric “chilliness at night”, which is a relatively small rubric that corresponds with this peculiar symptom of the case. However, I was not able to confirm this symptom in any materia medica.

 Silicea children can have chronic coryza as this child and great problems with concentration, which is a keynote of this remedy. They often tend to be shy and can cling to their mother, but they are usually calm. The strong restlessness of the body is a contraindication for Silicea in this case. Although Silicea is a very chilly remedy, we cannot find it in the rubric “chilliness at night” and it therefore does not cover this peculiar symptom. However, the most important contraindication for Silicea is the mental picture of the child, which is absolutely opposite to Silicea. The child is very hyperactive, restless and angry, whereas Silicea children are calm, easy to handle, and mild.

Aconitum comes up very high in the repertorization, especially because of its strong restlessness, which is its keynote. Aconitum belongs among the most restless remedies in the whole materia medica. However, Aconitum exhibits restlessness mainly during anxiety, whereas this boy has excessive energy, so it is physical restlessness, which is certainly not typical for Aconitum. We do not see any other confirmatory symptoms of Aconitum in this child and the remedy does not cover the delayed development and problems with coordination. Aconitum is listed in the rubric “chilliness at night”, but this symptom cannot be confirmed in the materia medica.      

Tarentula hispanica covers the case the best so far because physical restlessness is one of its main keynotes. Tarentula also covers the peculiar symptoms of the case, like the fascination with red objects and general amelioration from music very well. In this respect, it aspires to become the simillimum. However, this remedy does not cover the delayed development and problems with coordination. Although these complaints are explicable by the diagnosis and they are therefore common symptoms for children with Asperger’s syndrome, they are very intense in this case and it would be ideal to find a remedy, which covers not only peculiarities of the case but also the main complaints. The fact that Tarentula provided significant general amelioration in the past also confirms that it is very close to this case. However, the fact that the repetition did not have an effect despite the symptoms being the same, shows that it was only a partially similar remedy and not the simillimum.

Lycopodium is present in the rubrics we used for the repertorization, but none of the symptoms is its keynote, except the difficult concentration, which is connected to the diagnosis and it therefore belongs to common symptoms.

Mercurius solubilis is listed in the rubric for restlessness in the third degree. However, children who need this remedy are, on the contrary, very precocious in their development, whereas this boy’s development is delayed.

Baryta carbonica is a possibility especially because of the delayed development. However, Baryta carbonica lacks the leading symptom of the case – the strong physical restlessness. A remedy, which can be considered in connection with Baryta carbonica is Baryta iodata. This remedy is restless and delayed development is characteristic of it. However, Baryta iodata is a very warm remedy, whereas this child is chilly, especially at night.

Sulphur and Calcarea carbonica come up high in most repertorizations and that is why it is utterly important for their prescription to check presence of their keynotes in a given case. None of the symptoms of this boy are keynotes of Sulphur or Calcarea carbonica.

Bufo rana is an interesting remedy for this case, especially because of its delayed development. It covers the restlessness, although it is not a keynote of this remedy. Bufo also has a strong affinity to the nervous system and its psychological picture partially fits this case, as far as the anger is concerned. However, problems with coordination are not characteristic of this remedy. Bufo is neither listed in the rubric “chilliness at night” and does not cover any of the peculiar symptoms.

Result of the repertorization

None of the first ten remedies from the repertorization can be reliably confirmed. We cannot find a combination of the three main (leading) aspects of the case, namely the motor restlessness, problems with coordination and delayed development, in any of them. In order to find the simillimum, we have to work on the presumption that we are looking for a remedy which covers this specific combination. A good strategy to change the order of remedies in the repertorization and to bring forward those, which cover this combination, is to label these rubrics as “elimination”.

Repertorization using elimination method with labeled symptoms # 1, 4 and 6 as elimination

Note: When we label the mentioned rubrics as elimination, only those remedies that are present in all these three rubrics together will appear in the repertorization.

112341 MIND – RESTLESSNESS – children, in (&Elimination)50
212343MIND – RESTLESSNESS – bed – tossing about in172
312343MIND – FEAR – noise, from41
412343GENERALS – DEVELOPMENT – arrested (&Elimination)27
512342GENERALS – FOOD and DRINKS – tomatoes – desire3
612343EXTREMITIES – AWKWARDNESS – Lower limbs (&Elimination)14
712341EXTREMITIES – AWKWARDNESS – Hands – drops things26
812343MIND – CLINGING – children; in – mother; child clings to the6
912342MIND – CONCENTRATION – difficult300
1012342MIND – DULLNESS – children, in30
1112343CHILL – CHILLINESS – night24
1212343MIND – MUSIC – amel.22
1312342MIND – COLORS – red – desire for5

Result of the repertorization:

caust.bufoagar.
20/3617/1715/26
1111
221
32
4112
5
6313
71
8
9311
10112
1111
121
13

Analysis of the elimination repertorization

We excluded both Causticum and Bufo in the differential diagnosis (see above), but Agaricus has come up, which is the only remedy, apart from the two above mentioned ones, that comes through all the three important rubrics.

Although Agaricus is listed in the rubric for restlessness in the first degree only, it is one of its main keynotes as we can confirm in the materia medica. Delayed development, strong clinging to parents and motor restlessness together with the disturbance in motor activity and awkwardness are keynotes of Agaricus.

This situation again demonstrates how important it is to check every symptom carefully in the materia medica. It is important to notice that if we had relied only on the repertory, we could have missed Agaricus very easily.

Agaricus therefore not only covers the characteristic and leading symptoms of the case, but all these symptoms are also its keynotes. It can be found in the rubric “chilliness at night” and this symptom can be confirmed in Hering’s Guiding symptoms of our materia medica[1] where we read in blue letters (so in the second degree) in the chapter “sleep”: Restless night and chilliness.” This not only confirms the chilliness at night, but we can even see it here in connection with restless sleep, which is one of the main complaints of the child.

  1. Vithoulkas writes in his book Materia medica Viva:[2]Agaricus children are slow in walking, talking and learning. Their mind seems to develop slowly, which is why they make mistakes in speaking and writing later. They have a bad memory. They are also slow in comprehending and have difficulty in making decisions. They feel weak and are very attached to and dependent upon their parents. This is the reason why they may develop chorea or convulsions if they have been badly offended or reprimanded by their parents or teachers. Another aspect of Agaricus children is described by J. Metzer in his Materia Medica: “Nervous excessive liveliness of children with mental and motoric restlessness, they laugh, sing, dance and run about in a boisterous manner… With their great restlessness and fidgety nature, these children become a real trial for their parent’s patience. When playing they are wild, boisterous and incredibly agile; in spite of the talent they possess, they are poor achievers at school due to their flightiness. These children have no perseverance due to their mental and physical restlessness, they slip from one thing to the next and show no concentration whatsoever. Because of their fidgeting, they are clumsy with their hands and drop things. When lying in bed they move their bottom rhythmically or roll their head.”

Choice of the remedy, potency, and dosing

We know from the symptomatic picture of Agaricus in the materia medica that the main symptoms of the case (motor restlessness, delayed development, strong dependency on parents, problems with concentration, restless sleep, and motor awkwardness) are keynotes of this remedy. At the same time, the remedy also covers the symptom “chilliness at night”, which can be confirmed in the materia medica. Through a combination of these main and characteristic symptoms, the essence of the remedy Agaricus can be confirmed as G. Vithoulkas describes it in his book Materia Medica Viva. We can therefore confirm the remedy on the basis of the essence and keynotes. Agaricus does not cover the other peculiar symptoms like the amelioration from music and the desire for everything red. However, as it corresponds with the essence, which is unique and original for every remedy, it corresponds with the most important aspects of the case which make it the most individual, and which are the most characteristic of it. At the same time, we can say that no other remedy covers the mentioned combination of characteristic symptoms.

In people who are at the level C7, we should start with a potency up to 200C. Such a recommendation should really be followed in this case because of the serious diagnosis. On the other hand, when comparing the symptoms of the child with the materia medica, the picture of the remedy seems to be expressed very clearly (it contains a lot of keynotes of this remedy), which enables us to give the highest possible potency in his level of health, namely 200C. As the child is not taking any medication yet, it is best to start with a single split dose.

Recommendation: Agaricus 200C single split dose

Follow-up 1: March 10, 2013

The mother gave the remedy to the child on January 26, 2013, and the boy developed a fever on February 14, 2013. During the fever, he woke up frequently for the whole night and it was not possible to calm him down. The mother could not go out even to the next room. He was disinterested in everything, he was sneezing and his nose was obstructed.  On February 15, he developed wandering pains and the fever went up to 39.5°C. On February 16, he was diagnosed with otitis. He got antibiotics and his state got significantly better the next day.

He is much calmer in general and sleeps well. He only wakes once a night and the chilliness at night has improved too. He can play on his own and the aggressiveness is 70% less. His motor awkwardness has not changed. His dependency has improved a lot and he clings to the mother far less.

Analysis of the first follow-up

There has been a general improvement of the boy’s behavior, aggressiveness, dependency on the mother, and the chilliness at night after the remedy. The mother reported spontaneously that the motor restlessness (the strongest symptom of the child) has improved significantly. However, the occurrence of the acute disease with a high fever is the most important piece of information. Every time when the organism regains the ability to produce high fevers after a homeopathic remedy in a person who had not had a fever for a long time, it is a breakthrough moment and we can expect a significant improvement of the chronic complaints, however, provided that such a fever is not suppressed with antipyretics. The boy got antibiotics during the acute disease, which is something that leads to a general relapse in most cases.

A question may arise here how antibiotics can suppress an acute disease when they kill bacteria, which are considered to be the cause of such a disease in conventional medicine. One of the important differences between conventional medicine and homeopathy is that while conventional medicine considers bacteria to be the cause of a particular disease (L. Pasteur‘s theory) and it therefore opts for the therapy of killing the bacteria, homeopathy perceives the presence of the bacteria as a consequence of a disturbance, which allowed development of an environment hospitable to the bacteria and the infection could develop (A. Béchamp’s theory). So if a disturbance of the immune system occurs in an organism and as a consequence, an environment convenient for certain bacteria develops, these bacteria are a mere consequence of this disturbance and their eradication not only does not take away the true cause of the infection, but it also significantly weakens general immunity of the person. Although the infection subsides after antibiotics, these infections have a tendency to recur just because their real cause has not been eliminated with the antibiotics. If the disturbance is really cured, the inner environment inside the organism will change, the fertile ground for the bacteria will disappear and the bacteria will have difficultysurviving easily or to multipling. The person can be considered healthy if he feels well in general and the tendency to recurrent infections decreases. This is very important to realize because after repeated treatment with antibiotics, we often observe that after some time (which is individual for each person and it depends on the general resistance and strength of the immune system), the tendency to recurrent acute diseases like tonsillitis or bronchitis disappears, but chronic complaints develop. In this case, the disappearance of the sensitivity to acute diseases is not a sign of improvement but on the contrary, a sign of a significant decline of the state of the person whose immune system is so weak that it is unable to react through acute inflammatory processes and chronic complaints develop instead. The person then feels generally worse because his general state of health has worsened.

Nevertheless, in this case, there was no relapse after the antibiotics, which means that the child’s organism has a very good level of health, in spite of the seriousness of the diagnosis. The fact that he redeveloped a fever very shortly after the remedy, together with a very strong general improvement, which was not preceded by any perceivable aggravation points to a high level of health too. Although his motor activity is not better yet, his restlessness and psychological level have improved significantly and that (together with the occurrence of the acute disease with a high fever) makes further improvement of his state probable.

Recommendation: wait

Follow-up 2: September 15, 2013

Before they came for the follow-up, the mother had sent me the following e-mail:

“I would say that my son’s IQ has really risen very very much, as far as I can judge it. He concentrates better, and learns and comprehends faster. In comparison to April when I would have given him a mark 0 for the ability to serve himself, now I would rate him with a mark 9. He still sometimes makes troubles with food, but it cannot be compared with the previous state. Drinking from a bottle is the only thing we have not gotten rid of yet. He has learned to ride a bike and he now rides like mad, even without training wheels. On Sunday, he fell over the handlebar but fortunately, he ended up only with a bump on his head. He sleeps alone in his room for the whole night. Only the emotions, they are still as strong as before. Since the last follow-up, he had not been ill until last weekend when he got laryngitis from his brother, which lasted for 3 days. Then it was quite OK, although we had some regression of bedwetting. He should have commenced a school for autistic children, but the headmaster called me on Friday before the beginning of the school year saying that she could not accept him to the school because he was not an appropriate candidate, as he would stand out among other children mentally. She offered me that she could put him into a preparatory class. I was quite terrified, but it turned out to be a good choice. He is like an infant there and reportedly, they had even never had a four-year-old child there, but he likes it there. There are eight children and six of them are autistic. The oldest girl is nine years old. Their usual timetable comprises of daily four-hour teaching so he comes home quite exhausted but psychologically he feels easy. He is the fastest of the whole class to finish his tasks so he is then allowed to play quietly until the others finish their work too, but in spite of that, he never has enough as far as toys are concerned. He comes home and kisses all his tractors. Therefore, in general, he is much better. THANK YOU.”

About the author

Petr Zacharias

Petr Zacharias

Petr Zacharias is the founder and main teacher at the Prague College of Classical Homeopathy. He studied with George Vithoulkas at the IACH and has conducted seminars with Dr. A. U. Ramakrishnan, Dr. S. K. Banerjea, Dr. Jorgos Kavouras and Erik van Woensel.

10 Comments

  • really an excellent case!!
    Thank you so much for it and if possible keep providing us with this kind of analysis!!!
    As an IACH student my self i am really glad to see the amazing result of the correct way of practicing classical homeopathy, and being able to study from somebody who’s being tough by the same teacher is truly a delight!
    Through this you provided us with a complete way of approaching a case- and with the meaning of every step, according to prof. Vithoulkas teaching. I especially enjoyed the part of the three questions after the relapse, that is an issue that we definitely have to deal with!!
    So eventually, since 2013 did the chikd needed anything else? How is his current situation?
    best regards!!

    • Dear Angeliki, I lost the with the mother so unfortunatelly I dont know what is the current situation but as far as I know the amelioration which was reached is still there.

  • Dear Petr,
    it was really pleasure to reed this article, it is very informative, thank you. I don’t understand only how it is possible that half of the hemisphere don,t work ? What it means exactly?

  • thanks a lot sir for this detailed case. learned a lot.
    one query is that “how its possible that a symptom can not be in materia even though its present in repertory?”

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