An insight towards the Ayurvedic management of Trigeminal Neuralgia - A Single Case Report

Pooja Shivashimpar; AS Prashanth

doi:http://dx.doi.org/10.21760/jaims.8.7.34

An insight towards the Ayurvedic management of Trigeminal Neuralgia - A Single Case Report

Shivashimpar P.^1*, Prashanth A.²

DOI: http://dx.doi.org/10.21760/jaims.8.7.34

^1* Pooja Shivashimpar, Post Graduate Scholar, Department of Kayachikitsa, Ayurveda Mahavidyalaya and Hospital, Hubbali, Karnataka, India.

² AS Prashanth, HOD and Principal, Department of Kayachikitsa, Ayurveda Mahavidyalaya and Hospital, Hubbali, Karnataka, India.

One of the unpleasant conditions affecting the fifth cranial nerve, trigeminal neuralgia causes extreme unilateral pain in the areas served by its branches, along with stiffness in the temporal mandibular joint. Anticonvulsants, tricyclic antidepressants, and other surgical procedures are used to treat trigeminal neuralgia in contemporary medicines Initial adverse effects that are frequently experienced are ataxia, diplopia, nausea, and drowsiness. According to ancient Ayurvedic texts, this condition is closely related to the Sannipatika disease Ananthavata. Even the name suggests that the Vatadosha is highly vitiated. Anantavata is one of the 11 varieties of Shirorogas described by Acharya Sushruta. The treatment is based on Tridosha. The goal of the current study is to determine how effective Ayurveda medicine in Trigeminal neuralgia.

Keywords: Trigeminal neuralgia, Shiroroga, Anantavata

Corresponding Author	How to Cite this Article	To Browse
Pooja Shivashimpar, Post Graduate Scholar, Department of Kayachikitsa, Ayurveda Mahavidyalaya and Hospital, Hubbali, Karnataka, India. Email:	Pooja Shivashimpar, AS Prashanth, An insight towards the Ayurvedic management of Trigeminal Neuralgia - A Single Case Report. J Ayu Int Med Sci. 2023;8(7):181-183. Available From https://jaims.in/jaims/article/view/2619

Introduction

Trigeminal neuralgia is a neurological condition that causes stabbing pain in the cheek, eye, and lower area of the face as a result of irritation or pressure on the trigeminal nerve route, which exits the skull as the fifth cranial nerve. Although the pain rarely lasts longer than a few seconds or minutes, it can occasionally be so severe that the patient winces, hence the name "tic." They could happen on their own or in response to movements of the afflicted areas brought on by speaking, chewing, or smiling. trigger zones, generally on the face, lips, or tongue that set off attacks, are another distinguishing trait; patients may report that tactile stimuli - e.g. washing the face, brushing the teeth or exposure to a draft of air – generate excruciating pain^[1]

Trigeminal neuralgia, also known as tic douloureux disorder, affects 4-5 people out of every 100,000 people and is more common in women than in men.^[1]

The patients are heavily burdened by the discomfort caused by trigeminal neuralgia. Anti-convulsants like carbamazepine relieve pain in about 80 to 90 percent of users. Most patients have unpleasant side effects include nausea, fatigue, forgetfulness, unsteadiness, and dizziness. Sometimes the discomfort they cause is worse than the pain itself, forcing the patient to quit taking them. These drugs sometimes lose their effectiveness over time, too. Larger doses or multiple drugs must be taken at the same time. In order to treat individuals who are no longer responding to medication, surgery is employed.^[2]

The symptoms of Trigeminal neuralgia are comparable to those of Anantavata in Ayurveda. Acharya Sushruta has explained eleven Shirorogas and one of them is Anantvata.^[3]

In Anantavata, Tridosha are vitiated and cause severe intolerance pain at the back of the neck, eyeball, root of nose, temporal region and frontal region, associated with eye-diseases, lock jaw and shivering of jaw.^[4] The main treatments for Anantavata include Siravedha and Vata-Pitta Shamana.^[5]

Aim and Objectives

To study the efficacy of Ayurvedic management in trigeminal neuralgia with special reference to Ananthavata.

Materials and Methods

A 33 year old male patient was complaints of Trigeminal Neuralgia was selected from OPD Department of Kayachikitsa Ayurveda Mahavidyalaya and hospital, Hubballi, Karnataka.

Case Report

A 33-year-old male patient complaints of shooting, stabbing and shock like pain over temporal region, cheeks, forehead and face associated with stiffness of tempero mandibular joint.

A male patient of age 33 years was apparently healthy 4 years back. Gradually he started developing pain over the face, over the temporal region, which was radiating to cheek, forehead associated with stiffness of Temporomandibular joint. Pain was excruciating, with 10 to 12 episodes in a day, each episode persisting for 2 to 3 minutes. Pain was triggered and aggravates by chewing, cold weather, yawning, as well as due to physical and mental stress. Initially patient was taking painkiller medicines on self, when the pain was severe went to allopathy doctor and after his MRI-scan done he was diagnosed with Trigeminal Neuralgia due to nerve compression. He took allopathic treatment and got sustained relief for 6 months than gradually during the course of treatment observed giddiness which relieved on withdrawing the treatment. But for the complete recovery patient opted Ayurvedic treatment. So he came to our hospital for further treatment.

Personal history

Appetite: Decreased

Bowel: Constipation

Micturition: Normal

Sleep: Reduced

General examination

Weight - 75 kg

Height - 5.10 feet

Pulse - 78/min

Blood pressure - 120/80 mmHg

On examination

Tenderness - present over cheeks and chin

Range of movements - Stiffness in Temporomandibular joint

Investigation

Hb - 14.5gm%

ESR - 25 mm/hr

Treatment given

1. Sarvanga Abhyanga with Kayatirumeni Taila followed by Ksheeradhuma

2. Nasya with Balahathadi Taila

3. Yogabasti: Niruha Basti with Asanadi, Balapunarnavadi Kashaya

4. Anuvasana Basti with Ketakimuladi Taila, Chandanabalalakshadi Taila

Internal medicines

1. Shaddharana 1-0-1

2. Shirashuladivajra Rasa 1-0-1

3. Pathyadi Kadha 10ml-0-10ml

4. Manasamitra Vati 1-0-1

5. Manibhadra Lehya 0-0-1tsp6. Jyothishmati Taila 1-0-1

7. Dadimashtaka Churna ½ tsp -0-½ tsp with food

Observation and Result

The patient got moderate relief from the symptoms after the treatment. There was subjective improvement in quality of life and no pain was noticed on washing the face with soap after procedures and medications.

Discussion

Anantavata is a Vaatapradhana Tridoshaja Shiroroga whose symptoms are similar to those of Trigeminal Neuralgia. There are 11 Shirorogas listed by Acharya Sushruta, two of which, Ardhavabhedaka and Anantavata, share the primary symptom of a half-sided headache. The two differ only in that Ardhavabhedaka is a Pittapradhana and Anantavaata is a Vatapradhana Vyadhi

Here in Ananthavata, most of the symptoms supports the involvement of Vata. Increased Rooksha and Sheeta Guna of Vata causes

pain. Chala Guna of Vata is deranged and causes Hanugraha and Gandaparswa Kampa.

Currently, the patient's complaints are Vatapradhana. Vatahara and Brihmana line of treatment was consequently chosen. Abhyanga followed by Ksheera Dhuma which is Vatahara. Abhyanga corrects disorders caused due to Vata. As the entrance to Shiras, Nasya is a crucial line of therapy for Urdhwajatrugata Rogas. After Nasya Karma, the patient felt better. Nasya is effective in many brain disorders like depression, headache, migraine, Parkinson’s disease, memory loss, seizures, poor coordination, mental stress and depression because Vata, Pitta & Kapha said to be involved in Trigeminal neuralgia. Ultimately, Vata must be addressed, and only Sthanikashodhana of Vata i.e., Bastikarma will bring the condition under control. Thus, the disease's recurrence can be stopped.

Along with these therapies, oral medications are prescribed. Tab. Shaddharana which balances Vata. Shirashuladivajra Rasa which balances Tridosha and also helpful in management of Shirorogas. Pathyadi Kadha which mitigates Vata and Kapha. Manasamitra Vati which useful in management of anxiety, depression. So, these helped patient in reducing the disturbed sleep. Dadimashtaka Churna which is also aids Vatanulomana. Cap. Jyothishmati Taila also used to treat neurological disorder.

After taking these drugs patient got relief in the symptoms. Frequency of electric shock like pain was decreased and intensity of pain was also decreased So, in present case all medicines were used having Vatahara and Vataanulomaka properties that are found effective in symptomatic relief in Ananatvata (Trigeminal neuralgia).

Conclusion

In current study, it is observed that Ayurvedic treatment has provided significant relief in symptoms and found reduced recurrence. The ailment had significantly improved with the use of the proper internal Vatashamaka and Vatanulomana medications.

Reference

1. Anthony S. Fauci.[et al.], Harrisons principles of internal medicine, Vol 2, part 13, chapter 371, 17th edition pg 2583

2. Edited by Parveen Kumar, Michael Clark, Kumar and Clark’s Clinical medicine, Chapter 22, 8th edition 2012, Page no 1111

3. Vaidya Jadavji Trikamji Acharya. Sushrutasamhita, Uttara sthana, Chapter 25, Verse number 3-4. Varanasi; Chaukamba Orientalia. Reprint edition 2014. Page no 654

4. Vaidya Jadavji Trikamji Acharya. Sushrutasamhita, Uttara sthana, Chapter 25, Verse number 13 - 14. Varanasi; Chaukamba Orientalia. Reprint edition 2014. Page no 655

5. Vaidya Jadavji Trikamji Acharya. Sushrutasamhita, Uttara sthana, Chapter 26, Verse number 36 – 38 . Varanasi; Chaukamba Orientalia. Reprint edition 2014. Page no 658

6. KR Srikantha Murthy, Astanga Hridaya of Vagbhata, Volume 1, Sutrasthana, Chowkhamba Krishnadas Academy, Varanasi, 2009, Chapter 20th Verse1, page no-255.

Manuscript Received	Review Round 1	Review Round 2	Review Round 3	Accepted
2023-05-29	2023-05-31	2023-06-07	2023-06-14	2023-06-21
Conflict of Interest	Funding	Ethical Approval	Plagiarism X-checker	Note
Nil	Nil	Yes	16%

Case Report

Trigeminal Neuralgia

Journal of Ayurveda and Integrated Medical Sciences

An insight towards the Ayurvedic management of Trigeminal Neuralgia - A Single Case Report

Shivashimpar P.1*, Prashanth A.2

Introduction

Aim and Objectives

Materials and Methods

Case Report

Observation and Result

Discussion

Conclusion

Reference

Shivashimpar P.^1*, Prashanth A.²