HTML Full Text

Introduction

Now a days prevalence of neurological disorders are raising due to fast and stressful lifestyle. Unilateral facial palsy is common neurological problem.[1] A lower motor neuron tension of facial nerve results in paralysis of all the muscle of facial expression. Hence there is an absence of furrowing in the forehead, inability to close ipsilaterl eye (On attempted closure the eye ball rolls upward closure). This is the most common disease of the facial nerve. It affects men and women equally and is seen at  all stages. The incidence is probably higher in Diabetics.] Complete clinical paralysis, within the 1st 7 days indicates a poor prognosis. Patient in whom the  paralysis is incomplete throughout the clinical course invariably recover completely. Increasing age at onset and associated diseases like Diabetes or HTN indicate poor prognosis. Each of these separately may not be a reliable prognostic factor but two or more factors in same patient may be suggestive o poor prognosis. 

       Vata is responsible controlling all the body functions. [2]Acharya Charka has explained Ardit as contracture of mouth along with the involvement of forehead, eyebrow, eye, nasal fold on the affected side of face. He opines that Ardit is localized in half face with or without involvement of body.Madhav nidan has considered the involvement of face only.

      Nasya is one of the Pnchakarma procedure in which the drug ( Medicated oil/ ghee/ Decoction/ Powder) is administered through Nasa, essentially to eliminate the vitiated Dosha present in Sheera.

Aim and Objective

         To evaluate the effect of Ayurvedic Treatment  in Ardit (Bell’s Palsy)

Case Report: A 58 years old male having history of watering from left eye, difficulty in closing left eye, difficulty in moving up left eyebrow, heaviness in left ear and face, slurred speech, unable to inflate air in mouth, couldn’t make whistle. These all symptoms were since last 5 days before arriving at Kayachikitsa OPD of G.N.T. Hospital, Vidarbha Ayurved Mahavidyalaya Amravati. Patient was K/C/O DM & HTN since 2 years on regular medication.

Examination

• Body wt: 65 kg

• Heart rate: 70/min

• Respiratory rate: 16/min

• Temperature: Afebrile

• BP :140/90 mmhg

• CNS: Consious oriented

• CVS: Normal

• RS: AEBE clear

Ashtavidh Parikshan

1. Nadi: 70/min

2. Jivha: sam

3. Mala: Samyak Pravrutti(1_2) times/day)

4. Mutra:  Samyak Pravrutti (4_5 times/day )

5. Shabda: Aspashta

6. Sparsha: Samashitoshna

7. Druk: Atur

8. Akruti: Madyam

 As per the principle of Ardit Chikitsa described in Ayurvedic texts patient was treated with Nasya Karma along with Shaman Aushadhi.

Treatment given as follow[ 3]

Assessment Criteria[4] The assessment of the result was done by observing clinical signs and symptoms of Ardit as follows

• Mukhavakrata

• Nasavakrata

• Greevavakrata

• Netrastabdhata

• Waksang

• Lalastrava

Following examinations were also included in assessment criteria

1)Unable to close eyes

2)Unable to whistle

3)Unable to inflate mouth

Fig. 1

Discussion

Probable mode of action[5]

  Snehan karma with Mahamash tail stimulates the sensory nerve endings and provides strength to the facial muscle. Swedaan karma before nasya enhances local micro circulation by dilatation of blood vessels and increasing blood flow to the peripheral Arterioles which accelerates the drug absorption  and fast improvement.  [6] In Ashtanga samgraha it is explained that nasa being the entry of shira( head), the drug is administered through nostrils reaches through nostrils reaches shringataka marma, a sira marma by nasa strotas and spreads in the murdha(brain). According to Acharya Charaka Nasa is the portal( gateway) of shira.The drug administered through nasa as nasya reaches to the brain and eliminates only the morbid doshas responsible for producing disease.Ekangvir ras is herbo mineral medicine, it connstitute bhasma as ingredients are the most superior form of medicine. [7]Nighantu Ratnaka in Vatavyvadhi prakrana Ekangvir Ras has been mentioned for treatment of Pakshaghata and other Vatavyadhi. Vcha Churna is used as  lekhaniya draavya.Shunthisiddha eranda tail is uses as Anulomak for Vata dosha.

Result and Discussion

After 15 days of therapy 60% relief was found in watering from left eye, difficulty of in closing left eye, difficulty in moving up left eyebrow, heaviness in left ear and face, slurred speech, unable to inflate air in mouth, And after 30 days 100% relief was found in above symptoms . There was no side effect observed during treatment.

Conclusion

 From the present case study it was observed that Ayurvedic management described in classical text is helpful in giving significant relief in symptoms and signs of the disease Ardit (Bell’s Palsy), thereby improving quality of day by day life to the sufferer. Therapy like Nasya provides nourishment to the sense organs. More-ever the drugs used orally having additional effect in the relieving the signs and symptoms.