E-ISSN:2456-3110

Case Report

Bell’s Palsy

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 10 OCTOBER
Publisherwww.maharshicharaka.in

Ayurvedic management of Aradita (Bell’s Palsy) - A Case Study

Jain T1*, AP Vaijwade2
DOI:10.21760/jaims.9.10.49

1* Tanisha Jain, Post Graduate Scholar, Department of Shalakya Tantra, Government Ayurved College, Nagpur, Maharashtra, India.

2 AP Vaijwade, Head of Department and Associate Professor, Department of Shalakya Tantra, Government Ayurved College, Nagpur, Maharashtra, India.

Introduction: Bell's palsy or Facial nerve palsy is a condition that causes temporary weakness or paralysis of the muscles in the face. In Ayurveda, Ardita is a disease with functional disturbances affecting the Uthamanga (head) and stands close with the symptoms of Bell's palsy. This is the most common idiopathic unilateral lower motor neuron facial palsy that usually develops suddenly. Bell's palsy is treated with steroids, anti-inflammatory drugs, antivirals, and multivitamins in contemporary science, although the results are not good and the use of steroids has health risks. Ayurveda has a wide spectrum in terms of management from internal medications to an extend limit of Kriyakalpas and Panchakarma like Nasya, Ksheeradhuma, Sweda, Netra Tarpana, Jalauka Avacharan.

Case presentation: A 16-year male came to OPD with sudden left sided facial muscular weakness since 3 days ago. The treatment provided was Snehan, Shashtik Shali Pinda Sweda, Jalauka Avacharan, Nasya and Tarpan along with intake of Shamana medicines.

Conclusion: The pre and post-assessment was done with the help of House-Brackmann facial nerve grading system. Within the period of 15 days the patient showed significant improvement without any adverse effects.

Keywords: Ardita, Bell’s palsy, Jaloka Avcharan, Nasya, Tarpana

Corresponding Author How to Cite this Article To Browse
Tanisha Jain, Post Graduate Scholar, Department of Shalakya Tantra, Government Ayurved College, Nagpur, Maharashtra, India.
Email: 		Jain T, AP Vaijwade, Ayurvedic management of Aradita (Bell’s Palsy) - A Case Study. J Ayu Int Med Sci. 2024;9(10):294-298.
Available From
https://jaims.in/jaims/article/view/3660

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2024-09-14 2024-09-24 2024-10-04 2024-10-14 2024-10-23
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None Nil Yes 12.98

© 2024by Jain T, AP Vaijwadeand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

J Ayu Int Med Sci 2024;9(10)294
Tanisha J et al. Ayurvedic management of Aradita (Bell’s Palsy)

Introduction

Among the eighty Vata Nanatmaja Vyadhis mentioned in our Ayurvedic texts, Ardita is recognised as one. Additionally, because Shiras is the Adhistana in this entity, it is referred to as a Shiro Roga therefore seen as Shiro Roga as well. According to Charaka Acharya, the illness only affects the left half of the face, regardless of whether the body is affected. But according to Sushruta, Ardita is the only one whose face is impacted. Ekayaam is another name for Ardita. Ardita and facial palsy can be associated based on symptoms. The seventh cranial nerve is impacted by the common neurological condition known as facial palsy. The 7th cranial nerve is in charge of all voluntary movements of the face, taste perception in the anterior two thirds of the tongue, and regulation of salivary and lacrimal gland secretions. The incapacity of the affected side of the face to temporarily control its facial muscles is known as facial palsy. Along with eyelid drooping, ear ache, and taste changes, it might be characterized by weakening, twitching of the muscles, or complete lack of movement on the affected side. Possible Pathogenesis as per Ayurveda, an exacerbated Vata affects one half of the body, causing contractures in that side as well as drier blood in the hand, legs, and nee. As a result, the jaw, eyes, nose, forehead, eyebrows, and face all become crooked. Salivation is present, and the affected side's eyes stay half closed. As a result, when food is eaten, the affected side of the tongue also gets impacted. Additionally, the patient may experience speech impairments. Occasionally, one may also have pain in the hand, foot, eyes, temple, ear, and cheeks.

Case Report

  • A 16-year male had sudden left sided facial muscular weakness, partial closure of eyes, slurry speech, trapping of food particles in vestibule, dribbling saliva from right angle of mouth since 3 days.
  • BP, Pulse, RS, CVS, CNS, blood investigations- WNL

Clinical Examination

  • Eye

Distant and near V/A was 6/9 and N/6 respectively.
Palpebral aperture - Left eye > Right.
Partial eye closure and slow blinking in left eye.

Segment WNL

  • Ear

EAC, TM and hearing test- normal.

  • Nose

Nasolabial fold- Left side less demarked than right side.

  • Oral

Taste sensation for anterior 2/3of tongue- normal.
Mild slurred speech present.
Food collection on right vestibule- present,
Smiling sign- abnormal.
Forehead furrow and wrinkling- absent on left side

Therapeutic Intervention

Internal Shaman MedicationTab Palsi Nuron1tbBD14days
Swadisht Virechan Churna5gmHS14days
Local SnehanaDhanvantara TallaUrdhwangaLA30days
SwedanShashtik Shalipinda SwedaFollowing SnehanLA30days
GandushaNavaneetaFull of MouthBD30days
JalaukavacharanApanga PradeshiLTAlternate 3 days
NasyaPanchyendriya Vardhan Tail4 drops in each nostrilNext 7 days
Tarpan Triphala GhritaNext 7 days

Results

Before Treatment after Treatment

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Tanisha J et al. Ayurvedic management of Aradita (Bell’s Palsy)

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Before Treatment

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After Treatment

House-Brackmann facial nervr grading system
Clinical featureGradingScoreBTAT% Relief
Watering from left eyeNo010100%
Persistent but do not disturb routine work1
Persistent disturb routine work2
Constant3
Widening of palpebral Aperture (Netravikriti)No010100%
Slightly wide (Whole cornea visible)1
Moderate (cornea & 1/3upper sclera seen)2
Severe (cornea & 1/2 of upper sclera visible) 33
Absence of Nasolabial foldPresent normally030100%
fold seen while trying to speak1
fold seen while attempting to smile2
fold never seen3
Smiling signNormal020100%
Present without upward movement of Left mouth angle1
Present with upward movement of Right mouth angle2
Absent all the time3
Slurring of speechNormal010100%
Pronouncing with less efforts1
Pronouncing with great efforts2
Complete slurring3
Saliva dribbling from Lt angle of mouth (LalasravaAbsent020100%
Intermittent1
Constant but mild2
Constant and profuse3
Trapping of foodNo traping02150%

Discussion

In Samprapti of Ardita it is Prakupita, Vata Dosha which causes Sthana Samshraya to occur on one or both sides, which causes distortion of half the face, brow, forehead, eye, and mandible curvatures, as well as slurred speech, ear function cessation, loosening of the teeth, and hoarseness of voice. In addition, patients may experience difficulty swallowing food.


J Ayu Int Med Sci 2024;9(10)296
Tanisha J et al. Ayurvedic management of Aradita (Bell’s Palsy)

The treatment used in this situation is Vatahara and Bhrihmana Chikitsa because Vata Dosha is the primary cause of the illness. Four drops of Panchyendriya Vardhan Tail Nasya were administered to each nostril for seven days as part of this case study.

According to Acharya Vagbhata, Nasa Hi Shirasodwaram, Nasya is the first line of treatment for Urdwajatrugata Roga and to alleviate Vata Dosha Panchyendriya Vardhan Tail Nasya is used which has Bruhmana and Vatahara property so it reduces the symptoms of the disease. Panchyendriya Vardhan Tail Nasya, act as Brimhanakarma, Vatahara, gives strength to the facial muscle, reduces any type of irritation of nerves.

Considering patients Prakriti, Kostha and Vyadhi Dosha; Tab Palsinuron possess Vata-Shamaka properties along with other benefits such as mentioned below:

1. Improves metabolic processes in CNS & PNS, activates neuro-muscular communication.
2. Regulates blood supply in affected areas, overcomes anoxia, stimulates cerebro-neural activity.
3. Promotes healing of damaged nerves & blood vessels, Re-canalises blood vessels.
4. Provides nutrition support to nerves & blood vessels.

Each ingredient in Palsinuron Capsule benefits to its extent

Mahavatvidhwans: Improves metabolism of CNS & PNS, co-ordinates neuromuscular activity.

Sameerpannag: Improves tissue oxidation, overcomes anoxia, normalizes neuro-muscular metabolism.

Ekangveer Ras: Promotes healing of damaged nerves & blood vessels. recanalize blood vessels, activate sensory & motor functions.

Sootshekhar: Provides nutritional support for faster healing of damaged organelles.

Lajari: Regenerative effect on neuro-lesions.

Khurasani Owa: Checks neuro-irritation.

  • Swadisht Virechan Churna was used as Sukha Virechaka at bedtime.
  • Navaneeta Gandusha is Agryadravya for Ardita by Acharya Vagbhatta. It is Snigdha, Madhura and Vatapittahara; gives strength to local oral muscles.
  • Shastik Shali Pinda Sweda act as providing strength and rejuvenate the tissues and also to provide relief from pain, inflammation and stiffness.
  • Triphala Ghrita Tarpana; enhances local orbicularis oculi strength.

Conclusion

The current case proves that all above treatment modalities are helpful in alleviating the sign and symptoms found in Bell’s palsy (Arditavata) without any side effects. Also, patient approached to our OPD in very early stage; so, might be recovery of patient was good and fast.

References

1. Yadavji Trikamji Acharya, Chakrapani Dutta, Ayurveda Deepika Charaka Samhita Sutra, 1st Ed, Varanasi, Choukumbha Surabharati Prakashan,2000, 17/12, Pg.no. 99.
2. Tripathi Bramhnanda, Astanga Hridaya of Acharya Vagabhatta, Varanasi, Chaukhambha Sanskrit Pratisthana, Nidana Sthana 15/32-35, Pg-no.541.
3. Tripathi Brahmanand, Ashtang Hrdayam, Varanasi, Chukhambha Sanskrit Pratisthana, ChikitsaSathana 21/43, Pg.no.- 809.
4. Flint Beal, Stephen L. Hauser, Harrison's Internal Medicine, Trigeminal Neuralgia, Bell’s Palsy, and Other Cranial Nerve Disorders, 17th edition, part 16, pg.no.2584.
5. Flint Beal, Stephen L. Hauser, Harrison's internal Medicine, Trigeminal Neuralgia, Bell’s Palsy, and Other Cranial Nerve Disorders, 17th edition, part 16, pg.no.2584.
6. Gronseth GS, Paduga R. Evidence-Based Guideline update: Steroid and antivirals for Bell’s Palsy: Report of the guideline development subcommittee of the American Academy of Neurology. Neurology 2012 Nov7.
7. Tripathi Brahmanand, Ashtang Hrdayam, Varanasi, Chukhambha Sanskrit Pratisthana. Chikitsa Sathana 21/43.


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