On Examination
- General condition was fair
- Vitals were normal, afebrile
- Prakriti: Vata - Kaphaj
- Site of onset - Left side of the face
- Distribution - Unilateral
Treatment Protocol
| SN | Therapy | Drug | Doses |
|---|
| 1. | Shamana Chikitsa | 1. Ekangveer Rasa | 250mg, twice a day |
| 2. Mahavatavidhvansa Rasa | 250mg, twice a day |
| 3. Ashwagandha Churna | 2gm, twice a day |
| 4. Dashamoola Kwath and Grita | 20ml, twice a day |
| 5. Lashun Ksheera Paka | 20ml, once at morning |
| 2. | Nasya | 1. Shodhan Nasya - Shadbindu Taila | For first 3 days |
| 2. Pratimarsha Nasya - Anutaila | Twice a day |
| 3. | Yoga and meditation also advised to the patient |
Outcome Measures and Follow Up
After the completion of the treatment patient got almost complete relief from TN symptoms. As this treatment is more concentrated to treat the symptoms of T.N. patient followed the above intervention for the total duration of months with regular follow up. Patient didn't leave the treatment in this 4-month duration and followed all the advice given to him. He got relieved from all the symptoms in just 4 months.
Discussion
Trigeminal neuralgia is a neurological disease in which irritation or pressure on the trigeminal nerve (the fifth cranial nerve leave the skull) pathway causes a stabbing and sharp pain in the cheek, eye, temporal area and lower part of the face. The pain is usually located on only one side of the face. Symptoms of TN have similarity with Anantavata in Ayurveda. It is believed that all the Tridoshas get aggravated together and produce severe pain in the nape of the neck, eye brows and temples; there is throbbing pain at the sides of the cheeks and loss of movement of the lower jaw. Such symptoms produced by Tridoshas are called as Anantvata. In the treatment of Anantvata food which mitigates Vata and Pitta such as Payasa, Ghritpura etc. (all are sweet dishes) should be taken.[3] Preparations of rice boiled with milk and added with ghee should be advised to take regularly.
Shadbindu Taila and Anu Tail are an Ayurvedic medicated oils used for treatment of diseases related to head, brain, eyes, face, nose, ear, and neck because ‘Nasa Hi Sirso Dwaram’. Shadbindu Taila helps to take out vitiated Doshas from Siras. By using Anu Tail through nose, which is a door to brain and prevents 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 TN. Anu Tail helps to keep all the three Dosha in its balance state which helps to maintain harmony in body especially of supraclavicular (Urdhvajatrugata) parts of the body. It pacifies Vata, which plays a major role in development of TN. Anu Tail reduces Vata aggravation, improves nervine function and enhances the faster recovery from TN.[5] Ashwgandha also called Indian ginseng because of its rejuvenating effects on the CNS and endocrine system. Although Ashwagandha Churna is Tridoshahara. In many research trials it has been proven that Withania somnifera is most beneficial drug to treat many kind of diseases associated with inflammation in the body, such as cardiovascular, pulmonary, and autoimmune diseases and diabetes, cancers, and neurodegenerative diseases.[6] Ashwagandha also has anti-anxiety effect. However, many research studies shows that positive anxiolytic effects of Ashwagandha in adults.[7] Dashmool Kwath and Grita works on all three Doshas; Dashmool is Tridoshahara[9] but it predominantly pacifies Vata aggravation and Anantvata is also Tridoshaj Vyadhi but mainly Vata is affected. So, Dashmool is considered as good for TN. Dashmool also works as an anti-inflammatory and analgesic. Mahavata Vidhvansa Ras is used in the treatment of Vata and Pitta Dosha imbalance diseases such as paralysis, hemiplegia, facial palsy, tremors etc. It is also effective in Vata Pitta Pradhana disorders such as migraine and vertigo. Hence all these drugs help the patient to get rid completely of TN.
Conclusion
The case report demonstrates the treatment of Trigeminal Neuralgia completely treated with only oral Ayurvedic medicinal intervention. No surgical intervention was given. The proper diagnosis and treatment with Ayurveda science we can avoid many surgical treatment and complications with simple medicine and Patya Aptya Palana.
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