A 14-year journey from “unexplained headaches” to confirmed HSV-2 meningitis, highlighting how accurate diagnosis, antiviral botanicals, and individualized homeopathic prescribing can control severe neurologic symptoms and cardiac sequelae.
Deborah Frances RN, ND
This case report follows a 32-year-old woman with years of debilitating headaches later diagnosed as HSV-2 viral meningitis. It illustrates how thorough diagnosis, targeted antiviral herbal protocols, and sequential homeopathic treatment contributed to rapid symptom control, reduced emergency visits, and long-term neurological and cardiac stability.
Abstract
By attending to determinants of health, nourishing affected organs and stimulating the vital force, naturopathic physicians are often successful in treating patients even when a definitive diagnosis is unavailable. But it is never an ideal scenario.
The following case illustrates a situation where diagnosis was critical in properly assessing which organ systems to target. The ability of anti-viral herbs to address potentially dangerous symptoms quickly and effectively was impressive, even to this seasoned practitioner.
The Case
Nancy, a thirty-two-year-old, white female, first presented to the clinic in 2004 complaining of dull, pressive headaches of two years duration. Headaches occurred every one to four weeks and remained constant in both frequency and intensity. She described pain as global but worse in the frontal area. She denied sinus discharge and pain did not extend into maxillary sinuses. There was no nausea or vomiting or correlation to her menstrual cycles. The only concomitant symptom was muscle tightness in her neck, not unusual in any headache. Ibuprofen prescribed by her medical doctor did little to nothing to alleviate pain.
Other symptoms included mild fatigue and lifelong constipation which she managed with fiber, fluids and regular exercise. Her diet was exemplary. Sleep was good. Labs done by her allopathic practitioner, which included a CBC and comprehensive metabolic panel, were unremarkable.
Based on a presumptive diagnosis of tension headache Nancy was given a tincture formula of antispasmodic nervines including Actea racemosa, Pedicularis spp., Scutellaria lateriflora, Viburnum opulus, Eschscholzia californica, Piper methysticum and Passiflora incarnata. She was to take this formula 30 drops, four times daily, increasing the dose to every 15 minutes at the first sign of a headache. Homeopathic Natrum muriaticum LM-1 to take 200C twice per day was added based on her reserved nature, tendency to be perfectionistic, constipation and headaches.1 Nancy was already seeing a chiropractor and massage therapist on a regular basis.
Regular supplements included a good quality multiple B vitamin with minerals to which she had added an extra 150mg of magnesium.
Four Week Follow Up
When there was no change on follow-up four weeks later, both the remedy and the herbs were discontinued. A trial of another herbal tincture containing Tanacetum parthenium, Lavandula off. and Zingiber off. was prescribed to be taken 30 drops, three times daily before meals and every 15 minutes at the first sign of a headache, stopping if no improvement was noted after 4 or 5 doses. A hot foot bath with cold compresses to the head was also recommended for acute symptoms. But again, there was no change after four weeks.
The presence of a space occupying lesion seemed remote given that her symptoms had remained constant for two years, but because Nancy had experienced no change with either of the two herbal formulas, either one of which typically brings some modicum of relief to patients, I was puzzled. That combined with an inexplicable uneasiness that I was missing something, led me to suggest she seek more thorough diagnostic workup from an allopath, but she declined citing lack of insurance.
Fourteen Years Later
I did not see Nancy again until 2018 by which time she had obtained health insurance. When the intensity of her headaches finally drove her to the emergency room in 2016, a full workup was done including lumbar puncture where PCR testing of cerebral spinal fluid (CSF) resulted in a diagnosis of meningitis due to herpes simplex virus 2 (HSV2). She was placed on Valacyclovir 1000mg (Valtrex) and had been following up with her medical doctor since then.
Unfortunately, headaches had been increasing over the past 6 months in both frequency and intensity, sending her to the emergency room once or twice a month despite the Valtrex and the addition of L-lysine 2500 mg and Vitamin C 4000 mg in divided doses, which she increased to 5000 mg and 6000 mg respectively at the first sign of an episode. She had completely removed nuts and chocolate from her diet.
New symptoms included a prodrome that began with an aching sensation radiating down her left leg in a pattern consistent with sciatic nerve irritation. This was accompanied by further aching over the sacral area. Although increasing the L-lysine and Vitamin C often served to halt further progression of symptoms, prodromal symptoms were coming more often, even up to two or three times in a bad week.
“If the pain begins to go up my spine and into my neck, a headache is inevitable and I end up in the emergency room,” she said.
Pain was excruciating, dull and pressive with no shooting or throbbing. Intensity of pain was 10/10. There was still no nausea or vomiting. It is of some interest that Nancy had no history of herpetiform eruptions on the skin.
Nancy also reported a new symptom of heart palpitations starting six to eight months earlier. Two episodes of acute tachycardia had taken her to the emergency room where an EKG revealed supra-ventricular atrial tachycardia (SVAT).
Nancy was placed on a homeopathic remedy, two antiviral herbal formulas and one herbal cardiac formula. Herbs were all dispensed as a tincture.
Homeopathic Prescription
Nancy had a tendency to be fastidious, guilt-ridden and anxious. She described an intense fear of cancer and a “hypochondriacal” anxiety about health. A childhood history of significant verbal abuse by an older sibling had led her to be overly perfectionistic and responsible at a young age in an attempt to avoid criticism. These characteristics combined with emotional suppression and a fairly strong family history of cancer suggested homeopathic Carcinosinum. 2 The remedy was given in an LM-1 potency to be taken twice daily.
Chronic Herbal Formula
This formula, to be taken 60 drops three times per day was primarily composed of antiviral adaptogens to address immune function, mitigate anxiety, and strengthen the physiological response to stress via the hypothalamic-pituitary-adrenal (HPA) axis.
- Ocimum sanctum 2 parts
- Glycerrhiza glabra 1 part
- Uncaria tomentosa 2 parts
- Tilia europa 2 parts
- Hypericum perforatum 1 part
- Sig: 60 drops 3 times per day
Acute Herbal Formula
A compound of more acute acting anti-viral herbs was dispensed to be taken at the first sign of prodromal symptoms. The inclusion of multiple herbs in an acute formula allows for more vigorous dosing of the herbs without concern for exceeding the maximum amount of any one herb in the formula.
- Melissa officinalis 2 parts
- Hypericum perforatum 1 part
- Glycyrrhiza glabra 1 part
- Ligusticum porteri 2 parts
- Echinacea angustifolia 2 parts
- Sig: 60 drops every 15 minutes decreasing frequency as symptoms improve
Cardiac Herbal Formula
A 1:1 tincture of Leonurus cardiaca and Crataegus species was dispensed to address SVAT. Leonurus has shown itself to be reliably effective in clinic for easing functional heart palpitations, arrhythmias and SVAT. In addition to being a nervine specific to the cardiac plexus, bitters and flavonoids in the plant help reduce toxic load that is likely contributing to irritation of the cardiac nerve plexus. 3
By improving nutrition and blood flow to the heart, Crataegus has repeatedly shown itself in clinic to be efficacious in enhancing the action of other therapies aimed at improving cardiovascular health, thus acting as a supportive herb to Leonurus. Crataegus is cardiotonic, cardioprotective and tropho-restorative to the heart. Although it has antiarrhythmic activity, its action in this regard does not appear to be as strong as Leonurus.
- Leonurus cardiaca
- Crataegus spp.
- Mixed in 1:1 concentration
- Sig: 30 to 60 drops 4 times per day
First Follow Up
On follow up three weeks later, Nancy reported that prodromal symptoms were decreased by half. When symptoms did arise, the addition of frequent dosing of the acute herbal formulas in addition to the increased L-lysine and Vitamin C led to rapid resolution of acute symptoms within three to six doses of the herbs.
Cardiac palpitations were coming less often with the cardiac herbs and were far milder when they did occur.
The antiviral herbs were performing beyond even my expectations, but I was not so impressed with the remedy. Although Nancy was greatly reassured by her improvement thus far, she was still highly anxious and fearful. After allowing another two weeks for the remedy to act, I decided to prescribe lesionally.
Lesional Remedy
Based on the keynote symptom of radicular pain, I prescribed homeopathic Agaricus LM-1 twice daily with a 200C to hold for onset of prodromal symptoms. She was advised to continue the herbs as previously prescribed.
Agaricus is often an effective homeopathic remedy for radicular pain. Other indications that fit this case included muscle spasm, “intoxicant to the brain”4 and “irregular, tumultuous (heart) palpitations.”5
On follow-up three weeks later, Nancy reported “immediate relief” of radicular and low back pain with a single dose of 200C Agaricus. Frequency of prodromal symptoms were down to once every seven to ten days. There had been no visits to the emergency room since the herbs were first initiated.
Potency of Agaricus was increased to LM-2 then to each ascending level (LM-3, LM-4) every four weeks to prevent relapse. There was still no change in Nancy’s lack of confidence or anxiety. Since Agaricus was given as a lesional remedy, this was not surprising.
The remedy held for several months before it stopped working, even with ascending potencies. The lesional remedy had done its work. Now it was time to dig more deeply. Fortunately the herbs continued to be effective.
Constitutional Remedy
On reviewing the case, it was clear that I had been superficial in my original analysis. Oddly, I had not consciously registered the degree to which Nancy cringed in the face of the slightest criticism. She looked like a frightened child in these moments, her eyes pleading for mercy as her shoulders closed in to protect her heart. I also saw, for the first time, how overly clingy she was to her mom. This childlike presentation led me to prescribe Baryta carbonica (Bar-c) LM-16 twice daily with a 200C to take as needed for acute symptoms.
Four Week Follow Up
Four weeks later, Nancy reported feeling less anxious and her overall energy was improving. She reported only one mild episode of prodromal symptoms, which resolved quickly with a single dose of Bar-c 200C.
The homeopathic remedy, herbs and L-lysine were continued for several months, this time with lasting improvement. The Bar-c was discontinued ten months into treatment as it seemed to have done its work. The only hint of relapse occurred ten months later when an especially severe summer forest fire season left the valley where she lived submerged in toxic smoke. At this time prodromal symptoms of low back and radicular pain were recurring. She was again placed on Bar-c in LM dosing with a 200C to take as needed. This protocol kept her free of symptoms until autumn rains arrived three months later to clear the air, at which time the remedy was discontinued and has not been needed since.
Seven years later Nancy remains largely symptom free on L-lysine 500mg and Vitamin C 1000mg twice a day, sixty drops of the chronic anti-viral formula once to twice per day and Valacyclovir 1000mg per day. Her confidence is solid and strong. She is able to be assertive and is largely free of the anxiety that plagued so much of her life. She continues the cardiac formula but has dropped her dose to 30 drops once a day. Palpitations and episodes of SVAT are completely gone and missed beats are rare, occurring only if she goes off the Leonurus and Crataegus mix.
Concluding Remarks
Given the paucity of symptoms at the time of Nancy’s initial presentation in 2004 it is doubtful that further diagnostic evaluation would have included the lumbar puncture that incorporated PCR testing of CSF. The quick action of the herbs to bring Nancy out of crisis and facilitate healing is yet one more illustration of the beauty of naturopathic medicine.
Deborah Frances RN, ND first began working with nutrition and homeopathy as a registered nurse in the 1980’s before graduating from NCNM (now NUNM) with a certificate in homeopathy. After running a full time family practice in an underserved area of rural Oregon for several years, Dr. Frances returned to Portland to serve as adjunct faculty at NCNM (NUMN) and Bastyr University in Seattle.
Dr. Frances has been a popular lecturer at herbal and naturopathic conferences and published in several professional journals. Her approach to healing is strongly influenced by the teachings of her Lakota ancestry.
References
- Boericke, William MD. Pocket Manual of Homeopathic Materia Medica and Repertory. New Delhi, India: Jain; ed. 2002: 459-461.
- Vermeulen, Frans. Concordant Reference, Complete Classic Materia Medica. Belgium: Archibel; 2011: 520-521.
- Ritter M, Melichar K, Strahoer S, et al. Cardiac and electrophysiological effects of primary and refind extracts from Leonurus cardiaca. Planta Med. 2009; 62(5): 572-582.
- Boericke, William MD. Pocket Manual of Homeopathic Materia Medica and Repertory. New Delhi, India: Jain; ed. 2002: 19. Ibid. 22.
- Vermeulen, Frans. Concordant Reference, Complete Classic Materia Medica. Belgium: Archibel; 2001: 306.
