Changes

The fourth etiological factor of epilepsy is not following the prescribed rules of diet and lifestyle. The ''upayoga vidhi'' lists improper dietary habits, lifestyle and code of conduct that lead to disturbances in soma and psyche. Sushruta has elaborated the role of incorrect or excessive indulgence in activities of sense organs and locomotor organs as the foremost causative factor for ''apasmara''. This is suggestive of disturbances in the knowledge coordination chain leading to lack of attainment of knowledge. This factor also indicates role of unhealthy regimens and behavior in patho-physiology of epilepsy. The factor underlies ignorance towards proper ''dinacharya'' (diurnal regimen), ''ratricharya'' (night regimen) and ''ritucharya'' (seasonal regimen). The lifestyle and behavior of a person is important for achieving normalcy in the psychic plane and for avoiding psychological disorders. This also suggests the inclusion of ''prajnaparadha'' (intellectual blasphemy) described in [[Sharira Sthana]]. ''Achara rasayana'' (code of conduct) should be followed as a therapeutic regimen in the management of ''apasmara''. The psycho-neuro-biological basis of etiopathological factors causing neurological disorders is being extensively researched with positive outcomes. Psycho-social distress is an important underlying factor for such disorders through impairment of hypothalamo-pituitary-adrenal axis. The preventive measures to be included are correct and productive indulgence in the sensory and locomotor activities as per capacity of an individual. Psychotherapy is believed to be effective in the management of ''apasmara''.     

The fourth etiological factor of epilepsy is not following the prescribed rules of diet and lifestyle. The ''upayoga vidhi'' lists improper dietary habits, lifestyle and code of conduct that lead to disturbances in soma and psyche. Sushruta has elaborated the role of incorrect or excessive indulgence in activities of sense organs and locomotor organs as the foremost causative factor for ''apasmara''. This is suggestive of disturbances in the knowledge coordination chain leading to lack of attainment of knowledge. This factor also indicates role of unhealthy regimens and behavior in patho-physiology of epilepsy. The factor underlies ignorance towards proper ''dinacharya'' (diurnal regimen), ''ratricharya'' (night regimen) and ''ritucharya'' (seasonal regimen). The lifestyle and behavior of a person is important for achieving normalcy in the psychic plane and for avoiding psychological disorders. This also suggests the inclusion of ''prajnaparadha'' (intellectual blasphemy) described in [[Sharira Sthana]]. ''Achara rasayana'' (code of conduct) should be followed as a therapeutic regimen in the management of ''apasmara''. The psycho-neuro-biological basis of etiopathological factors causing neurological disorders is being extensively researched with positive outcomes. Psycho-social distress is an important underlying factor for such disorders through impairment of hypothalamo-pituitary-adrenal axis. The preventive measures to be included are correct and productive indulgence in the sensory and locomotor activities as per capacity of an individual. Psychotherapy is believed to be effective in the management of ''apasmara''.     

5. Improper techniques:

===== Improper techniques =====

Observance of improper tantra (techniques/methods) makes the person prone to apasmara and is the fifth causative factor. This includes iatrogenic factors such as improper follow ups of panchakarma procedures leading to vitiation of doshas in the body. The other meaning of tantra might be related to spiritual practices that are related to the supernatural powers mentioned earlier as reasons for causing epilepsy. Improper use of these tantric therapies can result in epilepsy.

 

Iatrogenic causes can increase susceptibility to apasmara. Therefore all procedures should be followed properly in order to prevent complications.   

Observance of improper ''tantra'' (techniques/methods) makes the person prone to ''apasmara'' and is the fifth causative factor. This includes iatrogenic factors such as improper follow ups of [[Panchakarma]] procedures leading to vitiation of ''doshas'' in the body. The other meaning of ''tantra'' might be related to spiritual practices that are related to the supernatural powers mentioned earlier as reasons for causing epilepsy. Improper use of these tantric therapies can result in epilepsy.

6. Incorrect postures and movements:

 

The sixth etiological factor , per Ayurveda, constitutes of wrong postures and movements. Since the coordination of movements is regulated by dhi-buddhi-smriti, any imbalance in the sense organs-mind-intellect-spirits sequence not only impairs movement of limbs but also increases the propensity of getting afflicted with apasmara. Conversely, wrong postures and movements are a result of disturbances in the sense organs-spirits sequence that lead to incorrect attainment of knowledge with the manifestation of apasmara.

Iatrogenic causes can increase susceptibility to ''apasmara''. Therefore all procedures should be followed properly in order to prevent complications.   

Uncomfortable sitting, sleeping, positioning, irregular, uncoordinated movements of body (e.g. improper dance, sports etc.) can predispose apasmara.    

 

7. Excessive degeneration and debility:

===== Incorrect postures and movements =====

 

The sixth etiological factor , per Ayurveda, constitutes of wrong postures and movements. Since the coordination of movements is regulated by ''dhi-buddhi-smriti'', any imbalance in the sense organs-mind-intellect-spirits sequence not only impairs movement of limbs but also increases the propensity of getting afflicted with ''apasmara''. Conversely, wrong postures and movements are a result of disturbances in the sense organs-spirits sequence that lead to incorrect attainment of knowledge with the manifestation of ''apasmara''.

 

Uncomfortable sitting, sleeping, positioning, irregular, uncoordinated movements of body (e.g. improper dance, sports etc.) can predispose ''apasmara''.

===== Excessive degeneration and debility =====

 

The seventh and last etiological factor i.e. excessive degeneration or debility may lead to pathogenesis of apasmara , pointing at dhatukshayajanya vataprakopa (vitiation of vata due to depletion of tissues) as a root cause. The degeneration might be a secondary condition resulting from other diseases. Hypo-perfusion and low levels of oxygen and metabolism could result in brain cell dysfunctions causing seizures. This is analogous to the concept of ati upakshaya in Ayurveda. Therefore, a clinical examination of depletion of tissues (dhatukshaya) could be considered as a treatment component in the management of apasmara. Acute and severe electrolyte imbalances (hyponatremia, hypocacemia and hypomagnesemia) frequently cause seizures.  

The seventh and last etiological factor i.e. excessive degeneration or debility may lead to pathogenesis of apasmara , pointing at dhatukshayajanya vataprakopa (vitiation of vata due to depletion of tissues) as a root cause. The degeneration might be a secondary condition resulting from other diseases. Hypo-perfusion and low levels of oxygen and metabolism could result in brain cell dysfunctions causing seizures. This is analogous to the concept of ati upakshaya in Ayurveda. Therefore, a clinical examination of depletion of tissues (dhatukshaya) could be considered as a treatment component in the management of apasmara. Acute and severe electrolyte imbalances (hyponatremia, hypocacemia and hypomagnesemia) frequently cause seizures.  

The underlying etiology of other degenerative diseases should be considered while dealing with cases of epilepsy. In that case, management of epilepsy should be supported by proper nutrition, restorative, replenishing and rejuvenation therapies.  

The underlying etiology of other degenerative diseases should be considered while dealing with cases of epilepsy. In that case, management of epilepsy should be supported by proper nutrition, restorative, replenishing and rejuvenation therapies.  

8. Additional factors by Sushruta: In addition to the above factors, Sushruta has quoted two more factors for predisposition of apasmara. Veganigraha sheelanam i.e. habitual suppression of natural urges and gachchatam cha rajaswalam i.e., having sexual intercourse with menstruating women can make the individual more susceptible to epilepsy. Recent research suggests that menotoxins secreted by the female body during menstruation significantly impact the psyche of a person accompanying that female.  

===== Additional factors by Sushruta =====

 

In addition to the above factors, Sushruta has quoted two more factors for predisposition of ''apasmara''. ''Veganigraha sheelanam'' i.e. habitual suppression of natural urges and ''gachchatam cha rajaswalam'' i.e., having sexual intercourse with menstruating women can make the individual more susceptible to epilepsy. Recent research suggests that menotoxins secreted by the female body during menstruation significantly impact the psyche of a person accompanying that female.  

 

On the first of these two factors, per Ayurveda, suppression of any of the thirteen types of natural urges may lead to various disorders. Suppressing natural urges leads to vata-dominant disorders and as vata is the regulator of mind-related activities, this consequently can result in neuropsychiatric disorders like apasmara. All the urges are stimulated, regulated and completed by the nervous system. Inhibition of these factors might lead to impairment of neurotransmission which can be a cause for neuropsychiatric disorders. Furthermore, suppression of urges can lead to accumulation of waste materials inside the body creating various diseases.  

On the first of these two factors, per Ayurveda, suppression of any of the thirteen types of natural urges may lead to various disorders. Suppressing natural urges leads to vata-dominant disorders and as vata is the regulator of mind-related activities, this consequently can result in neuropsychiatric disorders like apasmara. All the urges are stimulated, regulated and completed by the nervous system. Inhibition of these factors might lead to impairment of neurotransmission which can be a cause for neuropsychiatric disorders. Furthermore, suppression of urges can lead to accumulation of waste materials inside the body creating various diseases.  

On the second factor mentioned here, the correlation between having an intercourse with menstruating woman and getting afflicted with epilepsy needs to be researched further. Ayurveda strictly forbids sharing things with a menstruating woman, leave aside touching or having sexual relations with one. While there are reasons of following sacredness associated with this, sex with a menstruating woman is also indicative of exposure to unclean objects described earlier as the origin of apasmara. The psycho-neuro-endocrinological axis behind this view of Sushruta needs to be explored.    

On the second factor mentioned here, the correlation between having an intercourse with menstruating woman and getting afflicted with epilepsy needs to be researched further. Ayurveda strictly forbids sharing things with a menstruating woman, leave aside touching or having sexual relations with one. While there are reasons of following sacredness associated with this, sex with a menstruating woman is also indicative of exposure to unclean objects described earlier as the origin of apasmara. The psycho-neuro-endocrinological axis behind this view of Sushruta needs to be explored.

Thus, from the above descriptions, etiopathological factors of apasmara can be categorized into dietary factors, lifestyle factors, psychological factors, behavioral factors and iatrogenic factors. All the above predisposing factors can be scanned for epigenetic modifications with respect to personality types, behaviour patterns and occurrence of apasmara in such cases. This will be useful in identifying the disease at a primitive stage, breaking the pathogenesis at an intermedial stage and prevention of further deterioration and complications at later stage. There might be certain epigenetic patterns/changes due to the above mentioned etiological factors, which make the person more susceptible to get affected.  

Thus, from the above descriptions, etiopathological factors of apasmara can be categorized into dietary factors, lifestyle factors, psychological factors, behavioral factors and iatrogenic factors. All the above predisposing factors can be scanned for epigenetic modifications with respect to personality types, behaviour patterns and occurrence of apasmara in such cases. This will be useful in identifying the disease at a primitive stage, breaking the pathogenesis at an intermedial stage and prevention of further deterioration and complications at later stage. There might be certain epigenetic patterns/changes due to the above mentioned etiological factors, which make the person more susceptible to get affected.  

The above enlisted etiological factors cause depletion in psychological strength (objectively measured as Intelligence quotient (IQ) and Emotional Quotient (EQ). In the era of distress, it is important to know the etiology of a disease in order to prevent its harmful effects. In order to preserve and increase the psychological strength, one shall avoid the causative factors for apasmara.     

The above enlisted etiological factors cause depletion in psychological strength (objectively measured as Intelligence quotient (IQ) and Emotional Quotient (EQ). In the era of distress, it is important to know the etiology of a disease in order to prevent its harmful effects. In order to preserve and increase the psychological strength, one shall avoid the causative factors for apasmara.     

   

   

Fig.3: Psycho-dynamics in Apasmara  

Fig.3: Psycho-dynamics in Apasmara  

Fig.4: Satic presentation of pathogenesis of Apasmara  

Fig.4: Satic presentation of pathogenesis of Apasmara  

 

1. Sanchaya:  

1. Sanchaya:  

The first stage of accumulation of pathogenic factors (vitiated doshas) starts at their own sites. It is initiated right from the first exposure to unclean objects and other etiological factors mentioned earlier. This stage is characterized by mild disturbances in the psyche (rajas & tamas) and soma (tridosha).   

The first stage of accumulation of pathogenic factors (vitiated doshas) starts at their own sites. It is initiated right from the first exposure to unclean objects and other etiological factors mentioned earlier. This stage is characterized by mild disturbances in the psyche (rajas & tamas) and soma (tridosha).