Journal of Ayurveda and Integrated Medical Sciences

Introduction

Muscular dystrophy refers to a group of genetic disorders characterized by progressive muscle weakness and degeneration; the different types of Muscular dystrophies vary in terms of which muscles are affected. Duchenne muscular dystrophy (DMD), Becker muscular dystrophy (BMD), Emery- Dreifuss muscular dystrophy (EDMD), Limb- girdle muscular dystrophy (LGMD), Congenital muscular dystrophy (CMD), Myotonic muscular dystrophy (MMD), Fascioscapulohumeral muscular dystrophy (FSMD), Oculopharyngeal muscular dystrophy (OPMD) are common Muscular Dystrophies.^[1] Each of these disorders differs from pattern of inheritance, defective gene/ protein, onset, severity, clinical symptoms, affecting muscle groups.^[2] LGMDs are autosomal, heterogenous neuromuscular disorders of progressive weakness in limb girdle muscles, Primarily affects pelvic and shoulder girdle muscles. LGMD is the 4^th most common genetic cause of muscle weakness with an estimated prevalence in about 2 in every 100,000 individuals. Muscular Dystrophy patients are known to have mortality at younger age due to there is lack of effective managements. Present case is of autosomal recessive limb girdle muscular dystrophy in a child aged about 12 years which can be diagnosed as Mamsagatha Vaata^[3] which comes under the broad heading of the Vatavyadhi leading to progressive Maamsa Shosha is managed through the Ayurvedic line of management shows, with the help of systematic Ayurvedic line of treatment Muscular dystrophy can be managed successfully.

Case Report

A child aged about 12 years, came with the complaints of weakness in both the lower limbs, difficulty to get up from the squatting position and to sit from the standing position. At the age of 6 years child’s parents observed usage of hands to stand up from squatting position, difficulty in standing from sitting posture and to climb stairs with hands on the knees, Repeated fall while running or walking. The patient consulted Mazumdar Shaw Medical Center, Mysore in the year 2021. On investigation CPK level was 5134 U/L, LDH level was 947 U/L, vitamin D 21.30ng/ml and electromyography dated 13/07/2021 shows the myopathic patterns involving both proximal and distal limb muscles.

Table 3: Showing the Panchakarma procedures

Outcome

• Mild improvement was observed from parents and patient in waddling gait.
• Difficulty to stand and to sit reduced.
• Difficulty to walk and climbing up stairs reduced.
• Walking ability of the patient increased.
• Before treatment CPK was 5134 U/L, after treatment it reduced to 1294 U/L

Abhyanga with Balashwagandha Lakshadi Taila^[6]

This Taila contains:

Kashaya: Bala, Ashwagandha, Laksha

Kalka: Rasna, Chandana, Manjista, Durva, Yastimadhu, Choraka, Sariva, Ushira, Musta, Kushta, Agaru, Devadaru, Haridra, Kumuda, Harenuka, Shatapushpa, Padmakeshara.

Tila Taila

This Taila is used in different types of Vatavyadhi and this Taila is considered as Atyanta Pustikar, in present study patient is having Vata Vruddi and Mamsa Kshaya so this Taila is used for Abhyanga to regain strength by doing Vata Shamana.

Swedana with Shastika Shali Pinda Swedana

Shastika Shali Pinda Sweda is a form of Sankara Sweda where the ingredients like Shastika Shali (Tridoshahara, Balya, Pushtikara), Bala Mula Kwatha (Brumhana), Ksheera (Balya) are used. Over all Shastika Shali is a type of Swedana which also gives Snigdhata to the body and increases the Bala by controlling the vitiated Vata Dosha.

Mathra Basthi with Mahanarayana Taila

Kashaya Dravya: Shatavari, Shalaparni, Prushnaparni, Shati, Triphala, Erandamula, Brahati Phala, Kantakari Mula, Pootika Mula, Gavedhuka, Sahachara Tila taila, Go Dugdha and Aja Dugdha

Kalka Dravya: Punarnava, Vacha, Devadaru, Shatapushpa, Chandana, Agaru, Shaileya, Tagara, Kushta, Ela, Jatamamsi, Shalaparni, Bala, Ashwagandha, Saindhava, Rasna . This Taila is considered as Sarva Vata Nivaraka. Basti is a prime line of treatment for Vata by considering the age factor in the present case Matrabasthi was adopted.

Basti Karma: Mustadi Yapana Basthi^[7]

Mustadi Yapana Basthi is a Sarvakala Deya Basthi. This Basthi helps to increase Mamsa and Bala and gives Rasayana effect. So, in the present case this Basthi was adopted

Oral Medications
Balarishta with Dashamoolarishta

Balarishta Bala, Ashwagandha, Dhataki, Guda, Payasya, Eranda, Rasna, Prasarini, Lavanga, Usheera, Gokshura.

References

1. Mercuri E, Muntoni F. Muscular dystrophies. Lancet 2013;381:845e60. https://doi.org/10.1016/S0140-6736(12)61897-2. PMID: 23465426.
2. Mercuri E, Muntoni F. Muscular dystrophy: new challenges and review of the current clinical trials. Curr Opin Pediatr 2013;25:701e7. https://doi.org/ 10.1097/MOP.0b013e328365ace5. PMID: 24240289.
3. Vaidya Yadavji Trikamji Acharya edited Charaka Samhita, Sanskrit translation, Chikitsa stana, Chapter 28, sloka no 32, Page 617. Reprint 2021, Pub: Choukamba Orientalia, Varanasi.
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7. R. Srikantamurthy. Editor, English translation on illustrated Sushrutha Samhitha, Chikithsastana chapter 38, verse 111, 11th edition, Varanasi, Chaukhambha orientalia publication, 2012, p 381
8. Vidyanath, K Nishteshwar , Sahasrayogam, English translation, Arishta Prakarana, Shloka no 13, page no 240,Reprint 2008, Pub: Choukambha Sanskrit series office, Varanasi.
9. Vidyanath, K Nishteshwar, Sahasrayogam, English translation, Arishta Prakarana, Shloka no 1, page no 227,Reprint 2008, Pub: Choukambha Sanskrit series office, Varanasi