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==== Six stages of pathogenesis of epilepsy (''shatkriyakala'' for ''apasmara'') ====

==== Six stages of pathogenesis of epilepsy (''shatkriyakala'' for ''apasmara'') ====

   

   

===== ''Sanchaya'' =====

===== ''Sanchaya'' =====

Then, the ''vyakta'' i.e. manifestation stage of ''apasmara'' is apparent due to excessive aggravation of ''doshas''. The severity of paroxysms depends upon ''sharira bala'' (physical strength that helps do physical work as well as prevent manifestations of diseases, includes genetic predisposition as well), ''hetu'' (strength of causative agents depending upon their exposure) and ''sattva bala'' (strength of mind). The clinical manifestation will be a product of interactions between these factors. Common clinical features of the disease will start showing at this stage.  

Then, the ''vyakta'' i.e. manifestation stage of ''apasmara'' is apparent due to excessive aggravation of ''doshas''. The severity of paroxysms depends upon ''sharira bala'' (physical strength that helps do physical work as well as prevent manifestations of diseases, includes genetic predisposition as well), ''hetu'' (strength of causative agents depending upon their exposure) and ''sattva bala'' (strength of mind). The clinical manifestation will be a product of interactions between these factors. Common clinical features of the disease will start showing at this stage.  

6. Bheda avastha:

===== ''Bheda avastha'' =====

Bheda avastha is the stage of differentiation depending upon the dominance of doshas. This will predominantly depend upon the genetic constitution of the person as well as the intake of alleviators and pacifiers of that particular dosha. If there are some pacification factors in between, then the progression of disease stops at that stage only blocking presentation of clinical features.     

 

If we critically analyze and compare the pathophysiologies, it can be observed that unlike modern research, the brain did not figure in Caraka’s analysis of disease or their pathologic basis, nor did he emphasize the role of an exogenous or supernatural power (agantuka) factor in the causation of epilepsy. Charaka has clearly mentioned heart, the abode of self and consciousness, as the origin for apasmara. In the seizure state, doshas stride upwards through dhamanis (vessels), affecting the indriyas (sense and locomotor organs) leading to erratic movements and loss of consciousness. Sushruta and Vagbhata have specifically mentioned the samajnavahishu srotasu (channels of consciousness) as the pathway of spread of doshas and as a site for the disease.     

''Bheda avastha'' is the stage of differentiation depending upon the dominance of ''doshas''. This will predominantly depend upon the genetic constitution of the person as well as the intake of alleviators and pacifiers of that particular ''dosha''. If there are some pacification factors in between, then the progression of disease stops at that stage only blocking presentation of clinical features.     

      As per Ayurveda, the heart (and not the brain), is the locus or abode of the mind, consciousness and soul , and emotional factors are considered as some of the root causes for triggering epilepsy. The clinical presentation of epilepsy represents the derangement of functions of neurons of central nervous system, but the origin of this derangement shall have been predisposed much earlier due to psycho-pathological factors enlisted above. The acute onset of seizure can be precipitated due to emotional factors. The mechanism of this phenomenon and exact psycho-neuronal pathways behind this are worthy of study.   

If we critically analyze and compare the pathophysiology, it can be observed that unlike modern research, the brain did not figure in Charaka’s analysis of disease or their pathologic basis, nor did he emphasize the role of an exogenous or supernatural power (''agantuka'') factor in the causation of epilepsy. Charaka has clearly mentioned heart, the abode of self and consciousness, as the origin for ''apasmara''. In the seizure state, ''doshas'' stride upwards through ''dhamanis'' (vessels), affecting the ''indriyas'' (sense and locomotor organs) leading to erratic movements and loss of consciousness. Sushruta and Vagbhata have specifically mentioned the ''samajnavahishu srotasu'' (channels of consciousness) as the pathway of spread of ''doshas'' and as a site for the disease.     

      Prana vayu (buddhi-hridaya-indriya-chitta dhruk, i.e., regulation of intellect, heart, senses, mind functions), vyana vayu (seat at hridaya and regulating all types of movements), udana vayu (functions for energy and activities), sadhaka pitta (type of pitta dosha), tarpaka (type of kapha) and avalambaka kapha (type of kapha) are important to be considered as patho-physiological factors in this context.

 

As per [https://en.wikipedia.org/wiki/Ayurveda Ayurveda], the heart (and not the brain), is the locus or abode of the mind, consciousness and soul , and emotional factors are considered as some of the root causes for triggering epilepsy. The clinical presentation of epilepsy represents the derangement of functions of neurons of central nervous system, but the origin of this derangement shall have been predisposed much earlier due to psycho-pathological factors enlisted above. The acute onset of seizure can be precipitated due to emotional factors. The mechanism of this phenomenon and exact psycho-neuronal pathways behind this are worthy of study.   

 

''Prana vayu'' (''buddhi-hridaya-indriya-chitta dhruk'', i.e., regulation of intellect, heart, senses, mind functions), ''vyana vayu'' (seat at ''hridaya'' and regulating all types of movements), ''udana vayu'' (functions for energy and activities), ''sadhaka pitta'' (type of ''pitta dosha''), ''tarpaka'' (type of ''kapha'') and ''avalambaka kapha'' (type of ''kapha'') are important to be considered as patho-physiological factors in this context.

==== Types of apasmara ====

==== Types of apasmara ====