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Cover page of the Journal of Health Sciences


 
 Table of Contents  
CASE REPORT
Year : 2019  |  Volume : 12  |  Issue : 3  |  Page : 245-247

Management of hemiplegia (pakshaghat) through Ayurveda


Department of Kayachikitsa, All India Institute of Ayurveda, New Delhi, India

Date of Web Publication15-Oct-2019

Correspondence Address:
Dr. Prajapati Abhay
Department of Kayachikitsa, All India Institute of Ayurveda, Gautampuri, Sarita Vihar, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/kleuhsj.kleuhsj_38_19

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  Abstract 


Globally the incidence of non-communicable diseases is on the rise, drawing attention for its prevention and treatment. Hemiplegia is one amongst them, causing physical and mental instabilities. its prevalence is about 9 cases per 1000 in global population A male patient aged 38 years attending kayachikitsa OPD of AIIA, already diagnosed case of right sided hemiplegia. he took the treatment for 6 weeks. He didn't get satisfactory results so he came at AIIA. In this case there was involvement of kapha dosha along with dominancy of vaata dosha this condition is known as maarga avaranajanya. In this case because the patient taken the treatment timely and got complete relief after the total treatment duration of 68 days. the results was challenging in this case of pakshaghat after oral medication along with panchkarma treatment.

Keywords: Pakshaghat and hemiplegia, Panchkarma, shaman chikitsa


How to cite this article:
Abhay P, Swarnima M, Huddar V G. Management of hemiplegia (pakshaghat) through Ayurveda. Indian J Health Sci Biomed Res 2019;12:245-7

How to cite this URL:
Abhay P, Swarnima M, Huddar V G. Management of hemiplegia (pakshaghat) through Ayurveda. Indian J Health Sci Biomed Res [serial online] 2019 [cited 2019 Nov 21];12:245-7. Available from: http://www.ijournalhs.org/text.asp?2019/12/3/245/269203




  Introduction Top


Globally, the incidence of noncommunicable diseases is on the rise, drawing attention for its prevention and treatment. Hemiplegia is one among them, causing physical and mental instabilities. Its prevalence is about 9 cases/1000 in the global population. Worldwide, cerebrovascular accidents (stroke) are the second leading cause of death and the third leading cause of disability.[1] Hemiplegia is a condition of total or partial paralysis of one side of the body, with numbness in limbs, slurred speech, etc., Cerebrovascular accidents such as thromboembolism and hemorrhage of cerebral arteries considered to be the major cause for this condition. This presentation is akin to a condition called Pakshaghata in Ayurveda (Ch.chi. 28/53). As it is explained by Acharya Maadhava, “saadhyam anyen samyuktam[2] means pakshaghat along with other dosha is easily curable. A case of pakshaghat is presented here.


  Case Report Top


A male patient aged 38 years attending kayachikitsa outpatient department of All India Institute of Ayurveda (AIIA), New Delhi, presented with difficulty in walking (kuryaat cheshtaa nivrattih), unable to do work with the right-sided limbs (Ardhkaayastasya akarmanyo vichetanam),[3] numbness in the right upper and lower limbs (Hatvaa ekam paksham dakshinam),[4] and slurred speech (vaak stambhamev cha) for 2 month and he was diagnosed with right hemiplegia. Before 2 months, he was asymptomatic and suddenly he felt cramps and severe numbness in the right side of his body; again on the next day, his complaints became severe then he went to the hospital there. Non contrast computed tomography (NCCT) of the head was done and was found normal within the 24 h of attack, then he took the treatment including physiotherapy [5],[6],[7] for 1 month, and an anticoagulant drug [6] was started during allopathic course of the treatment. He took the treatment for 6 weeks. He did not get satisfactory results, so he came to the AIIA.

Physical examination

  • On doing neurological examination [8]
  • (HMF) higher mental functions – intact
  • Sensory nerve functions were found intact
  • The patient was well oriented to person, place, and time [Table 1] and [Table 2].
Table 1: Motor system examination

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Table 2: Tendon reflexes findings

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Samprapti (pathogenesis)

Occupationally the patient was lobour having madhyama bala(medium physical strength). his work was to lift heavy weight and to carry it. on the day of paralysis attack he was continuously working without taking meal. in charaka samhita it is mentioned that heavy physical work and langhana both leads to vaata prakopa this aggravated vaata get enter into sira through raktavaha strotasa and then it affected the snayu of right side of body and then loss of function of right side of body settled.after that concequences like difficulty in walking, unable to raise right upper and lower limb were seen.

During the course of treatment, the patient was instructed to avoid cold exposure and heavy exercise or work and was advised to take brumhana, ushna aahar such as maamsa ras, and milk [Table 3].
Table 3: Treatment plan

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  Results Top


After 8 days of the treatment (Yoga Basti along with shaman chikitsa), the patient observed mild reduction in symptoms and gradual improvement in strength of the limbs [Table 4]. He achieved movements of the right upper and lower limbs to some extent. The patient's speech improved and he was able to walk without support, approximately 50 m at a time.
Table 4: Motor system examination before and after treatment

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At the time of discharge, Dhandhanayadi kashayam 15 ml before meal was added to the shaman chikitsa to reduce the rest of the vitiated vaata dosha. During the treatment, the patient at the first follow-up complained of difficulty in penis erection and burning sensation during micturition, and then Chandraprabha vati 2 bd was added for 1 month. After 2 months of the treatment at the 2nd follow -up, the patient's all symptoms had subsided completely, and superficial and deep reflexes were found normal [Table 4].


  Discussion Top


As discussed above, this particular condition is known as pakshaghat in Ayurveda, and Acharya Maadhava clearly described the prognosis of pakshaghat and said that pakshaghat in the result of the only vitiation of vaata has a bad prognosis, but along with vaata if there is involvement of pitta or kapha, the disease has a good prognosis.


  Conclusion Top


In this case, if there was involvement of kapha dosha along with dominancy of vaata dosha, this condition is known as maarga avaranajanya. In this case, the patient took the treatment timely and got complete relief after a total treatment duration of 68 days. The results were challenging in this case of pakshaghat after oral medication along with panchkarma treatment.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.[10]



 
  References Top

1.
Global Health Estimates. Geneva: World Health Organization; 2012. Available from: http://www.who.int/healthinfo/global_burden_disease/en. [Last accessed on 2016 Jun 01].  Back to cited text no. 1
    
2.
Bramashankar S. Vatavyadhi nidanam. Madhukosha Vyakhya, Madhav Nidan. Sloka no. 43. reprint edition 2012. Part 1. chaukhambha publication, varanasi; 2010. p. 163.  Back to cited text no. 2
    
3.
Bramashankar S. Vatavyadhi nidanam. Madhukosha Vyakhya, Madhav Nidan. Sloka no. 40. reprint edition 2012. Part 1. Chaukhambha publication, varanas; 2010. p. 163.  Back to cited text no. 3
    
4.
Dwivedi LD. Chikitsa sthan. Chakrapani Teeka Charak Samhita. Shlok no. 53. 2nd ed., Ch. 28. Varanasi: Choukhamba Sanskrit Samsthana; 2016. p. 921.  Back to cited text no. 4
    
5.
Keshner EA. Reevaluating the theoretical model underlying the neurodevelopmental theory. A literature review. Phys Ther 1981;61:1035-40.  Back to cited text no. 5
    
6.
Lennon SM. The Bobath concept: A critical review of the theoretical assumptions that guide physiotherapy practice in stroke rehabilitation. Phys Ther Rev 1996;1:35-45.  Back to cited text no. 6
    
7.
Norris JW, Htchinsky VC. prevention of stroke, springer science business media, LLC, 1991.  Back to cited text no. 7
    
8.
Houghton AR, Gray D. Chamberlain's symptoms and sign in clinical medicine, chapter 12,13th Edition, Edward Arnold Publishers Ltd, London, 2010.  Back to cited text no. 8
    
9.
Dwivedi LD. Chikitsa sthan. Chakrapani Teeka Charak Samhita. Shlok no. 100. 2nd ed., Ch. 28. Varanasi: Choukhamba Sanskrit Samsthana; 2016. p. 932.  Back to cited text no. 9
    
10.
Dwivedi LD. Chikitsa sthan. Chakrapani Teeka Charak Samhita. Shlok no. 86. 2nd ed. Ch. 28. Varanasi: Choukhamba Sanskrit Samsthana; 2016. p. 929.  Back to cited text no. 10
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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   Abstract
  Introduction
  Case Report
  Results
  Discussion
  Conclusion
   References
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