E-ISSN:2456-3110

Case Report

Multiple Sclerosis

Journal of Ayurveda and Integrated Medical Sciences

2025 Volume 10 Number 9 September
Publisherwww.maharshicharaka.in

Ayurveda management of Multiple Sclerosis - A Case Report

Chaudhary M1*, Goyal M2, Mehta C3
DOI:10.21760/jaims.10.9.60

1* Manisha Chaudhary, Post Graduate Scholar, Department of Kayachikitsa, Institute of Teaching and Research in Ayurveda, Jamnagar, Gujarat, India.

2 Mandip Goyal, HOD, Department of Kayachikitsa, Institute of Teaching and Research in Ayurveda, Jamnagar, Gujarat, India.

3 Charmi Mehta, Lecturer, Department of Kayachikitsa, Institute of Teaching and Research in Ayurveda, Jamnagar, Gujarat, India.

Multiple sclerosis is a chronic and progressive disorder that presents with various cognitive, motor, and sensory impairments. This autoimmune disease occurs when the immune system damages the myelin sheath surrounding nerve fibres, disrupting communication between the brain and the rest of the body. Although corticosteroids are commonly prescribed in conventional medicine, they often fail to provide comprehensive or sustained relief. In Ayurveda, while there is no explicit mention of multiple sclerosis, the condition can be classified under Vatavyadhi (~neurological and musculoskeletal disorders due to vitiation of Vata Doṣha) based on its clinical characteristics. A 54-year-old female homemaker presented with continuous, throbbing pain in the right temporal region, radiating to her neck, right upper back, and both upper and lower limbs for the past two years. She has a known history of multiple sclerosis, confirmed by MRI reports indicating chronic demyelinating lesions. In Ayurveda, she was diagnosed with Kaphavrita Vyana Vata. The treatment plan included Deepana Pachana with Anulomana, Basti Karma (~medicated enema), and Nasya Karma (~therapeutic nasal instillation of medicated oils), along with Shamana Chikitsa (~conservative therapy). Throughout her treatment, she was advised to follow Pathya-Apathya (~wholesome diet and lifestyle) to support the management of Vata Vyadhi. After three months of treatment, significant improvement was observed. The assessment of disease severity and quality of life using the FAMS scale, Berg Balance Scale, and SF-36 revealed significant improvements. This single case report demonstrates the effectiveness of Ayurvedic treatments for conditions similar to multiple sclerosis.

Keywords: Basti Karma, Kaphavr̥ta Vyana Vata, Majja Kṣhaya, Multiple Sclerosis

Corresponding Author How to Cite this Article To Browse
Manisha Chaudhary, Post Graduate Scholar, Department of Kayachikitsa, Institute of Teaching and Research in Ayurveda, Jamnagar, Gujarat, India.
Email: 		Chaudhary M, Goyal M, Mehta C, Ayurveda management of Multiple Sclerosis - A Case Report. J Ayu Int Med Sci. 2025;10(9):370-376.
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https://jaims.in/jaims/article/view/4711/

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2025-07-15 2025-07-26 2025-08-05 2025-08-15 2025-08-27
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© 2025by Chaudhary M, Goyal M, Mehta C and 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].

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Manisha C et al. Ayurveda management of Multiple Sclerosis

Introduction

Multiple Sclerosis (MS) is a chronic, immune-mediated neurological disorder of the central nervous system (CNS), characterized by inflammation, demyelination, and neurodegeneration. It occurs when the immune system mistakenly attacks the myelin sheath, resulting in impaired nerve conduction and progressive neurological dysfunction. MS presents with a wide range of clinical manifestations, including sensory disturbances, motor weakness, optic neuritis, fatigue, and cognitive impairment.[1]

The disease is classified into various clinical types, such as Relapsing-Remitting MS (RRMS), Primary Progressive MS (PPMS), and Secondary Progressive MS (SPMS). Diagnosis is established based on clinical evaluation, magnetic resonance imaging (MRI) showing demyelinating lesions in the white matter, cerebrospinal fluid (CSF) analysis revealing oligoclonal bands, and evoked potential studies.[2]

Globally, MS affects approximately 2.8 million individuals, with a higher prevalence among women and in temperate climates. It is a leading cause of disability among young adults and significantly affects quality of life and functional independence. Due to its chronic and progressive nature and the absence of a definitive cure, long-term management strategies are essential. These include immunomodulatory therapies, neurorehabilitation, and lifestyle modifications.[3] The importance of MS lies in the necessity for early diagnosis, comprehensive treatment, and integrative approaches. Ayurveda offers a holistic perspective, potentially contributing through neuroprotective effects, immune modulation, and symptomatic relief. From an Ayurvedic perspective, MS is not described explicitly in classical texts, its clinical manifestations can be interpreted through the framework of conditions such as Kaphavr̥ta Vyana Vata, Avaranajanya Vata Vyadhi, and Majja Dhatu Kṣhaya.[4] The core pathogenesis involves the obstruction (Avaraṇa) of Vyana Vata by Kapha Dosha, leading to impairment in sensory and motor functions. This is further compounded by the depletion of Majja Dhatu, which weakens the structural and functional integrity of the nervous system. The disease process primarily affects the Majjavaha and Rasavaha Srotas, resulting in a progressive neuromuscular decline

marked by symptoms such as muscle weakness, stiffness, fatigue, and impaired coordination. [5]

Case Report

A 54-year-old female homemaker presented with complaints of pain and weakness on the right side of her body, along with discomfort in the right ocular region, persisting for the past one year. On further inquiry, the patient reported that approximately two years ago, she experienced fever, right-sided body weakness, diplopia in the right eye, and a headache localized over the right temporal region. She consulted an allopathic physician at that time and was diagnosed with Multiple Sclerosis. She was started on prednisolone along with supportive medications, which she continued for one year. This treatment resulted in improvement in most symptoms, except for persistent right-sided weakness. Over the past year, she has continued to experience right-sided body weakness, now accompanied by pain in the same region and persistent discomfort in the right ocular area. The patient has presented to the Ayurvedic hospital seeking further management for her persistent symptoms.

She was on medication, including tab prednisolones 5 mg twice a day, tab amitriptyline 25 mg twice a day and tab famotidine 40 mg twice a day. She had no history of hypertension, liver disorders, or significant family medical history.

Clinical findings

On general examination, there was no pallor, icterus, cyanosis, clubbing, lymphadenopathy, or oedema. The blood pressure was 130/80 mm Hg, and pulse was 72 beat per minute (feeble and regular). The BMI was 26.5 kg/m2.

Ashtavidha Pariksha (~eight-fold examination of patient) was done, which revealed Nadi (~pulse) Pitta-Vata Pradhana, Mootra Pravriti (~urination) 3-4 time/day, once at night time, dark yellowish in colour, Mala pravriti (~bowel habit) once a day, hard and unsatisfactory. Jihwa (~tongue) was whitish and coated, Madhyama Aakriti (~mesomorph).

On systemic examination, respiratory examination revealed bilateral equal air entry with no added sounds. Cardio-vascular examination revealed normal heart sound without murmurs.


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In gastro-intestinal examination, umbilicus centrally located and there was no tenderness on palpation. The patient was conscious and oriented to time, place and person. Cranial nerve examination intact, except optic nerve in which right eye was unable to do addiction movement.

Diagnostic assessment

Chronic demyelination in periventricular and frontal- parietal lobe white matter, suggestive of Multiple sclerosis. On basis of clinical feature and MRI finding it is diagnosed as a case of multiple sclerosis. The SF-36 health survey[6], Berg Balance Scale[7], and Functional Assessment of Multiple Sclerosis (FAMS)[8] score were utilized to evaluate the effect of therapy on overall health status, balance, and disease-specific quality of life in this patient.

Timeline

Detailed timeline of events is illustrated in table no. 1.

Table 1: Timeline

Time periodsEvent
2nd March, 20221st episode of Multiple sclerosis (fever, headache, diplopia, weakness in B/L lower leg, pain and weakness in right side of the body
4th March, 2022MRI brain showed primary demyelinating lesion with B/L optic neuropathy
5th March, 2022VEP scan and eye scan report normal, no possibility of optic neuropathy
6th March, 2022Diagnosed as Multiple sclerosis and stared allopathy Rx
March 2022 to December 2023Diplopia and headache not present but generalized weakness persist, patients on allopathy Rx (Tab prednisolone and Tab. Amitriptyline hydrocholoride)
Jan, 2024Generalized weakness, pain and weakness on right side of the body again started
2 Jan, 2024Admitted at Kayachikitsa indoor patient department, ITRA, Jamnagar
03 Jan – 08 Jan 2024Deepana-Pachana with Chitrakadi Vati and Eranda Bhrishta Haritaki for 5 days.
09 Jan – 24 Jan 2024Yapana Basti administered daily for 16 days
26 Jan – 01 Feb 2024Nasya Karma with Kshirabala Taila for 7 days in increasing dosage.
02 Feb – 02 May 2024Shamana Chikitsa – Phase I with internal medications continued for 3 months.
03 May – 19 May 2024Second cycle of Yapana Basti and Nasya karma.
20 May – 20 Aug 2024Shamana chikitsa – Phase II continued for another 3 months.
02 Sept 2024Repeat MRI showed no progression of demyelination.
Sept 2024Final follow-up: Allopathic medications stopped; complete resolution of symptoms; no adverse effects reported.

Therapeutic intervention

The treatment protocol was systematically planned following a thorough assessment of the patient's condition and after obtaining informed consent. The intervention began with Deepana-Pachana therapy to enhance digestive function and correct metabolic imbalance. For this, Chitrakadi Vati (2 tablets, three times daily) was administered with lukewarm water before lunch and dinner, along with Erand Bhrishta Haritaki (5 g) taken with lukewarm water one hour before bedtime for the first five days.

Following this preparatory phase, the patient underwent Yapana Basti for 16 days, followed by Marsha Nasya with Kshirabala Taila for 7 days. Thereafter, Shamana Chikitsa (palliative management) was continued for three months. After this phase, the same sequence of Yapana Basti and Nasya was repeated, followed again by a three-month course of Shamana Chikitsa. This cyclic therapeutic approach was adopted to maintain long-term efficacy and provide sustained symptomatic relief.

The details of the treatment were mentioned in table no. 2.

Table 2: Details of the treatment

InterventionComposition and Method of AdministrationDurationTreatment Period
Yapana BastiAdministered as a medicated enema containing:
Madhu (Honey) - 30 ml
Saindhava Lavana (Rock Salt) - 5 g
Go-Ghrita (Cow Ghee) - 30 ml
Bala Taila - 30 ml
Putoyavanyadi Kalka - 20 g
Kshira Kashaya (Milk decoction) of Ashwagandha, Bala, Guduchi, Yashtimadhu, and Shatavari - 250 ml		16 days09 January 2024 – 24 January 2024
Nasya KarmaMarsha Nasya performed with Kshirabala Taila, administered in increasing dosage pattern: 2–4–6–8–10–12–14 drops over consecutive days.7 days26 January 2024 – 01 February 2024

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Shamana ChikitsaInternal medication regimen included:
1.  Dashamoola Kwatha - 20 ml, twice daily on an empty stomach
2.  Yogaraja Guggulu - 2 tablets, thrice daily after meals with lukewarm water
3.  Eranda Bhrishta Haritaki - 5 g at bedtime with lukewarm water
4.  Ashwagandha Churna - 2 g + Bala Churna - 1 g + Pippalimoola - 500 mg + Vatavidhvamsa Rasa - 125 mg, twice daily with lukewarm water		3 months02 February 2024 – 02 May 2024

Follow up and outcome

At the time of discharge, the patient was instructed to follow a prescribed oral medication regimen in the outpatient setting and scheduled for weekly follow-up visits. The patient's progress was assessed at three points: prior to the initiation of Ayurvedic treatment, at discharge, and after six months of treatment. After seven months of treatment the patient experienced complete resolution of symptoms such as pain and weakness on right side of the body along with pain in the right ocular region. Allopathic medications were gradually discontinued during the course of treatment. There was no adverse drug’s reaction during treatment. Details documented in Table No. 3.

Table 3: Details of outcome of the treatment

ParameterBefore treatmentAfter treatment
Generalized weakness+4+1
Pain and weakness at right side of the bodyVAS – 5VAS- 1
Pain at right eye region (retro –orbital region)+20
Accommodation reflex in rt eyeUnable to perform addictionAble to do
FAMS scale150160
Berg balance scale5056
SF – 369095
MRI brainChronic demyelination in periventricular and frontal- parietal lobe white matter, suggestive of Multiple sclerosisSame as previous, no further progression

Discussion

Discussion on disease pathology

In this case, the initial pathology began with Kaphavrita Vyana Vata, wherein the vitiated Kapha Dosha obstructed the normal functioning of Vyana Vata. This Avarana led to symptoms such as right-sided pain, motor dysfunction, and ocular disturbances, reflecting Vata-Kapha Dushti in the Urdhva Sharira and particularly the involvement of Majjavaha and Rasavaha Srotas. Over time, the persistent Avarana not only disturbed the free movement of Vata but also impaired the Dhatu Poshana (~nourishment of tissues) process by causing Srotorodha (~channel obstruction). As per Ayurvedic principles, such chronic obstruction of Vata, when unrelieved, results in Vata Prakopa and eventually leads to Dhatu Kshaya. In this case, the progressive loss of neuromuscular strength and the MRI-confirmed demyelination correlate with Majja Dhatu Kshaya, particularly in the context of long-standing Vata aggravation. This progression from Avaraṇa to aggravated Vata, culminating in Dhatu Kṣaya, is consistent with classical Ayurvedic principles, which describe unresolved Avaraṇa as a key factor contributing to impaired tissue nourishment and subsequent degeneration over time. [9]

Discussion on treatment

Agnidipana (~ stimulation of digestion): Chitrakadi vati possesses Katurasa(~pungent taste), Usnavirya (~ hot potency), and the qualities of Laghu (~lightness) and Ruksha(~Dryness), which support Agnidipana and Aam Pachana (~detoxification by eliminating undigested toxins).[10] Eranda bhrishta haritaki was administered for its Mriduvirechaka (~mild laxative) effect. [11] Yapana Basti, indicated for all seasons, is valued for its Balya (~strengthening), Rasayana (~rejuvenative), and Vṛṣya (~vitalizing) effects. Its formulation supports Dhatu Poshana, especially of Majja Dhatu, which is functionally associated with the central nervous system in Ayurveda. Yapana Basti offers nourishment and regeneration through ingredients like Ksheera, Ghrita, Madhu, and Pippali. These components enhance strength, improve neurological function, and address Dhatu Kshaya. [12]

Nasya with Kṣhirabala Taila effectively pacifies Vata dosha and enhances cerebral circulation through the vascular pathway. This action may aid in preventing demyelination, reducing neuroinflammation, and supporting the maintenance of cognitive functions. The unctuous and nourishing qualities of Kṣhirabala Taila


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, combined with the trans nasal delivery method, facilitate targeted benefits to the brain and central nervous system, making it a valuable intervention in conditions involving Majja Kṣhaya and neurodegeneration, such as Multiple Sclerosis. [13]

Dashamoola Kwatha is effective in the management of Kaphavr̥ta Vyana Vata associated with Majja kṣhaya due to its Tikta and Kaṣhaya Rasa, Uṣhṇa virya, Laghu and Rukṣha Guna, which help in alleviating Srotorodha.[14] Additionally, it supports Ama pachana thereby improving circulation and nerve function. By nourishing and supporting Majjā Dhātu, it becomes effective in managing symptoms such as pain, stiffness, and sensory disturbances commonly seen in neurodegenerative conditions. Yogaraja Guggalu is Vedanasthapaka and Vatahara Karma.[15] Ashwagandha (Withania somnifera Linn.) possesses significant antioxidant and neuroprotective properties, making it highly relevant in the management of neurodegenerative. It supports muscle strength, stimulates regenerative processes, and modulates the hypothalamic–pituitary–adrenal (HPA) axis, leading to reduced cortisol levels and enhanced stress resilience.[16] These actions contribute to the alleviation of fatigue, muscle weakness, and inflammatory responses commonly observed in MS. Bala (Sida cordifolia Linn.), characterized by Madhura Rasa, Shita Virya, and Madhura Vipaka, exhibits Balya and Bṛṃhaṇa, properties. Its anti-inflammatory and neuroprotective effects support the reduction of neural inflammation and promote the regeneration of Majja Dhatu.[17] Pippali Moola possesses Katu Rasa (~pungent taste), Laghu and Tikṣṇa Guna, Uṣṇa Virya (~hot potency), Madhura Vipaka, and Kaphavatahara property. Due to these properties, it acts as Dipana, Pachana, and Srotoshodhaka,[18] thereby improving circulation and neural communication. Piperine, the active constituent of Piper longum, has demonstrated potential to promote remyelination and cognitive recovery in hippocampal demyelination through its antioxidant, anti-inflammatory, and neuroprotective mechanisms.[19] Additionally, classical formulations like Vatavidhvansa Rasa, comprising herbs with Kaṭu–Tikta Rasa, Uṣṇa Virya, and Vata–Kaphahara properties, are traditionally indicated in Vatavyadhi conditions. These formulations exhibit Shoolapasamana (~analgesic), Sothnashaka (~anti-inflammatory), Rasayana, and Bṛṃhaṇa actions. Collectively, these interventions help

pacify aggravated Vata dosha, prevent Dhatu Kṣhaya, and support nervous system health in patients with Multiple Sclerosis exhibiting signs of Majjā Kṣhaya. [20]

Clinical Assessment Interpretation

SF-36 (Short Form Health Survey): This scale evaluates overall health-related quality of life across eight domains, including physical functioning, vitality, and general health. The post-treatment improvement in SF-36 scores reflects enhancement in both physical and mental well-being. This improvement signifies effective management of fatigue, weakness, and emotional stress, which are symptoms associated with chronic Vata vitiation resulting from Avaraṇa and progressive Majja Dhatu Kṣhaya.

Berg Balance Scale (BBS): The BBS assesses postural balance and risk of falls. The observed improvement in BBS scores after therapy suggests enhanced neuromuscular coordination and proprioceptive control, correlates with the correction of Kaphavrita Vyana Vata and the improved Dhatu Poshana through therapies such as Yapana Basti, Nasya, and Rasayana intervention.

FAMS (Functional Assessment of Multiple Sclerosis): This MS-specific tool evaluates mobility, symptoms, emotional status, and overall quality of life. The increase in FAMS score post-treatment reflects comprehensive functional recovery, which aligns with the effects of Vatahara, Avaraṇa-Uddharaṇa, and Majja-Prada Rasayana therapies aimed at restoring Dehabala, Satvabala, and Majja Dhatu strength.

Conclusion

This case report provides preliminary evidence on the potential efficacy of Ayurvedic treatments in managing and enhancing the quality of life for patients with Multiple sclerosis. Nevertheless, to validate its scientific benefits, additional research involving a larger sample size and longer duration is necessary.

Declaration of the patient

Written patient consent was taken by the author before this case report was published in any print or online journal. The parents and patient were informed that her name and initials would not be published, and reasonable efforts would be made


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to conceal her identity. However, complete anonymity cannot be guaranteed.

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