Abstract
Background: Migraine is one of the leading causes of morbidity and disability in the world. Its prevalence ranges from 5 to 40% in the pediatric population, with about 50% of these headaches continuing to adulthood. Incidental diagnosis of pineal cysts (PCs) is on the rise with the evolution of imaging techniques; the causal relationship of PC and individuals with headache however remains controversial, and complete resolution is uncommon. Conventional medicine stresses on the importance of tailored therapy in the management of pediatric migraine.
Case Report: An 11-year-old female, diagnosed with migraine with an aura and PC, was benefitted by individualized classical homeopathic therapy using the homeopathic preparation Phosphorous and Natrum muriaticum. The symptoms of migraine improved, and the incidentally diagnosed PC completely resolved during the course of treatment.
Conclusion: Individualized classical homeopathy may have a role in effectively treating migraines and PCs in the pediatric population. There is a need for further scientific investigation with well-designed studies to prove the effectiveness of this therapeutic method, taking care to maintain the individualization principle of classical homeopathy.
Zusammenfassung
Hintergrund: Migräne ist eine der führenden Ursachen für Krankheitslast und Behinderung weltweit. Ihre Prävalenz bei Kindern und Jugendlichen liegt im Bereich von 5–40%; hiervon sind etwa 50% bis ins Erwachsenenalter von den Kopfschmerzen betroffen. Zufallsdiagnosen von Pinealiszysten (PC) kommen im Zuge des Fortschritts bei den bildgebenden Verfahren immer häufiger vor, jedoch ist ein kausaler Zusammenhang der PC mit Kopfschmerzen umstritten, und ein vollständige Rückbildung kommt nicht häufig vor. Die Schulmedizin betont, wie wichtig eine maßgeschneiderte Therapie bei der Behandlung der Migräne im Kindesalter ist.Fallbericht: Ein 11-jähriges Mädchen, bei dem eine Migräne mit Aura und eine Pinealiszyste diagnostiziert wurde, profitierte von einer individualisierten klassisch-homöopathischen Therapie mit den homöopathischen Präparaten Phosphorus und Natrum muriaticum. Die Migränesymptome besserten sich, und die zufällig diagnostizierte Pinealiszyste bildete sich im Laufe der Behandlung vollständig zurück.Schlussfolgerung: Die individualisierte klassische Homöopathie kann bei der wirksamen Behandlung von Migräne und Pinealiszysten bei Kindern und Jugendlichen eine Rolle spielen. Es bedarf weiterer wissenschaftlicher Untersuchungen mit gutem Studiendesign, um die Wirksamkeit dieser Behandlungsmethode nachzuweisen, wobei darauf zu achten ist, das Individualisierungsprinzip der klassischen Homöopathie aufrechtzuerhalten.
Keywords: Migräne mit aura, Kopfschmerzen, Zysten des zentralen Nervensystems, Homöopathie
Journal Section:
Case Report / Kasuistik
Keywords:
Migraine with aura, Headache, Central nervous system cysts, Homeopathy
Introduction
Migraine is a primary headache disorder affecting 5–40% of the pediatric population [1]. The treatment involves various pharmacologic and non-pharmacologic measures, ranging from stress management, trigger avoidance, and lifestyle modification, to use of analgesics, with no standardized management established so far [2]. Population-based surveys showed that in about 50% of the children, the migraine remained status quo [3, 4]. Females are more likely to be affected by persistent headaches after puberty in the pediatric population. In addition, positive family history of one parent and migrainous headaches during childhood increases the likelihood of higher headache frequency in the long term [1]. About 1.9% of the pediatric population with migraine undergoing intracranial imaging show pineal cyst (PC) lesions [5]. Though vast majorities of PCs are asymptomatic, studies have demonstrated a significant relationship between headaches and PCs; however, its causal relationship remains controversial [6, 7].
Conventional therapy of PC includes conservative management of symptoms and surgical resection based on the size of the cyst [8]. Management of PC or its improvement homeopathically has not been documented so far. We present a case of pediatric migraine with incidental diagnosis of PC, where the headaches improved along with regression in the size of the cyst.
Case Report
The patient, an 11-year-old female, presented for a homeopathic consultation on February 22, 2018.
Presenting Complaints and Disease History
The patient had one-sided headaches preceded by an aura, with a transitory loss of vision in the form of central scotoma or contralateral hemianopia. The vision was dim or foggy at times. Later episodes were followed by formication of the left hand and vomiting, without ameliorative effect. About 10 episodes of headache were seen in 6 months, where the patient used analgesics like paracetamol or ibuprofen. Headaches lingered for 2 days after conventional therapy.
Medical History
The patient had two episodes of head injury, at 1.5 years and 6 years of age, with a concussion during the second incident, where the response time was delayed for 3 h. She had atopic dermatitis during her early childhood, Mycoplasma pneumoniae infection at 3 years of age, recurrent herpetic eruptions on the nasal mucosa at the age of 9 years, and recurrent aphthae since the age of 10 years. She is also allergic to fur and pollen. The patient was regularly attended to, by conventional medicine specialists.
Family History
The child’s parent and maternal grandmother had a positive medical history of migraine…….
