Introduction

Bell’s palsy or idiopathic facial nerve palsy is a condition that involves any age group and both genders.^[1] Bell’s palsy has an incidence of 23 cases per 100,000 population/year, or about 1 in 60 to 70 people in a lifetime.^[2]

Numerous viruses have been linked with Bell’s palsy. Active or reactivation of herpes simplex or varicella-zoster virus is probably the most common causes of bell’s palsy. Least common causes include Otitis media, Epstein Barr-virus, Cytomegalovirus, Mumps etc. A typical patient complains of retro auricular pain that may precede facial weakness, incomplete closure of the affected side.^[3]

Patient often describes the face as ‘Numb’ but there is no objective sensory loss (except possibly to taste). In Ayurveda it can be correlated with Ardita a Vyadhi mentioned in Ayurveda classics. Ardita is one among the 80 Vatajananatmajavyadhis. Various Acharyas like Charaka, Sushruta explained causes of Ardita like transferring heavy weight on head, excessive laughing, loud talking, sudden fearing, sleeping on uneven bed, eating hard food particles and Vatvardhak Ahara-Vihara leading to vitiation of Vata Dosha and causing Ardita. Acharya Charaka mentioned that its features are seen in one half of face, trunk, extremities or they may be restricted only to face and is episodic in nature.^[4]

Acharya Sushruta opines that Ardita involves one lateral of face only and is non-episodic in nature.^[5] Acharya Vagbhata specifies it as the manifestation in the half of face along with the involvement of half of the body.^[6]

When it comes to treatment all of them treated Ardita as a Vata Vyadhi and stated various therapies like Nasya Karma, Akshitarpana, Karnapoorana, etc. Bell's palsy usually resolves within 3 weeks - 6 months^[7] but it may lead to various complications like permanent eye injury, chronic loss of taste, moderate-to severe facial asymmetry which can be devastating.^[8]

It is estimated that 4-7% of all cases of Bell's palsy have recurrent facial palsy.^[9]

This case reports the effectiveness of Ayurvedic treatment in the management of Bell’s palsy for speedy recovery from symptoms and to avoid long term consequences.

Ashtavidh Parikshana:

Table 2: Ashtavidha Parikshana

Central nervous system examination:

• Higher Motor Functions - Intact
• Consciousness - Conscious
• Orientation to time, place, person - Intact
• Memory (Recent and Remote) - Intact
• Intelligence - Intact
• Hallucination and Delusion - Absent
• Speech - Slurring of speech with difficulty in speaking

Reflexes:

• Corneal reflex: consensual response intact, closure of right eyelid diminished.
• Deep Tendon Reflexes of all limbs: Normal.
• Muscle power and Muscle tone of all limbs: Normal.

Cranial nerve examinations:

• Neurological examination of all cranial nerves was performed and found intact except facial nerve.

Table 3: Facial nerve examination

Roga Pareeksha

Nidana:

• Prajagara (sleeps late at night)

Figure 1: Before treatment

Nasya provides nourishment to the nervous system by neural, diffusion and vascular pathway.^[16] Tarpana provides nourishment and strength to the eye.^[17]

It also helps in watering from eyes.^[18] Karnapoorana nourishes and stimulates the nerve endings. It pacifies pain in ear and also improve the hearing quality.^[19]

Cap. Palsineuron - Ekangaveera Rasa used orally act as Brinhana, Rasayana, Vishaghna which helps in enhancing the speed of recovery in the patients of Ardita.^[20] Sanshamani Vati - Guduchi has Rasayana properties which helps in rejuvenation of all Dhatus in the body.^[21] Maharasnadi Kashaya pacify the Vata and corrected their flow in the body. Gandharva Haritaki powder - Mild purgative which induces Vatanuloman (downward flow of Vata) and relieves constipation. It helps to relieved a Pakvshayagata Vata has laxative properties pacify Vata from the Pakvashaya.

Conclusion

Ardita (Bell’s palsy) can be effectively managed by classical treatment given in Ayurveda texts. All therapies like Sthanik Snehana, Nadisweda, Nasya, Akshitarpana, Karnapoorana as a combined treatment pacify the vitiated Vata in the body and thus provide nourishment to the sense organs. Vatakapha Shamak, Bruhana, Vata Anulomaka properties of the oral medications help in relieving the sign and symptoms thereby improving quality of life of the sufferer.

References