Hemiplegia (paralysis or hemiparesis) is known as ‘pakshaghata’ or ‘pakshavadha’ in Ayurveda. It is classified under 80 diseases due to the vitiation of vata dosha (nanatmaja vata vyadhi). There is complete or partial paralysis of the arm, leg, and trunk on one side of the body. The most typical cause of hemiplegia is cerebrovascular stroke. A stroke affecting the corticospinal tract results in hemiplegia. Other causes are trauma, diabetes, infections affecting the nervous system, neoplasms, demyelination disorders, congenital disorders, multiple sclerosis, parasomnia etc. As per Ayurveda pathophysiology, the vitiated vata dosha afflicts half of the body by causing desiccation of nerves or blood vessels (sira) and muscles or tendons (snayu). It finally results in the signs and symptoms of pakshaghata. [Cha.Sa. Chikitsa Sthana 53-55] Rehabilitation is the primary treatment of hemiplegia to regain maximum function and quality of life. It includes both physical and occupational therapy. Ayurvedic management is vatahara (pacification of vata dosha) in nature. It can improve motor functions by vatanulomana (proper elimination of flatus, faeces, urine etc., by proper functioning of vāyu) and balya (which provides strength) forms of medications.
| Section/Chapter/topic | Concepts & Contemporary Practices/Diseases/Pakshaghata |
|---|---|
| Authors | Adarsh P. M. 1, Deole Y.S. 2 |
| Reviewer & Editor | Basisht G.3 |
| Affiliations |
1 Charak Samhita Research, Training and Development Centre, I.T.R.A., Jamnagar, India 2 Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India 3 Rheumatologist, Orlando, Florida, U.S.A. |
| Correspondence emails | dryogeshdeole@gmail.com, carakasamhita@gmail.com |
| Publisher | Charak Samhita Research, Training and Development Centre, I.T.R.A., Jamnagar, India |
| Date of publication: | October 10, 2023 |
| DOI | In process |
National Ayurveda Morbidity code: AAC-24
ICD code for: G81.90
Causes (hetu)
Aggravating factors of vata dosha lead to hemiplegia. These include following:
· Excessive intake of tikta (bitter), katu (pungent) and kashaya (astringent) tastes.
· Consuming insufficient quantity of food
· Excess intake of food items having dry quality.
· Late-time food consumption
· Suppression and provocation of natural urges.
· Avoidance of sleep at night
· Excess talking in a loud tone
· Excessive application of purificatory therapies
· Fear, grief, excessive thinking
· Excess exercise and sexual intercourse beyond one’s capacity. [A. Hri.Nidana Sthana 1/14-15][1]
· Injury to vital organs (marmaghata)
· Untreated chronic inflammations or infections
Clinical features
General clinical features
· Loss of motor function and pain on either side of the body (right or left)
· Slurring or loss of speech
· Contractions (spasticity) on the legs and hands on either side.
· Pricking pain or sharp pain in the body. [Cha.Sa. Chikitsa Sthana 28/53-55]
· Loss of activity (akarmanyata), and loss of sensation (achetana) of the affected side. [Su.Sa. Nidana Sthana 1/60-62][2]
Dosha specific clinical features
| Dosha associated | Clinical features |
| Pitta associated condition | Burning sensation (daha)
Increase in body temperature (santapa) Syncope (murchha) |
| Kapha associated condition | Coldness (shaitya)
Swelling (shotha) Heaviness (gurutva) |
[Ma.Ni.22/42][3]
Pathogenesis
The vata dosha is aggravated due to two possible pathologies:
1. Depletion of body constituents (dhatu kshaya)
2. Obstruction or covering of vata dosha by other dosha or body constituents (dhatu, mala)
These two causes provide a background for pathogenesis of vata dominant diseases.
The aggravated vata is lodged in vacant spaces or afflicted channels (sroto vaigunya). Due to obstruction in its path or impaired movement, vata dosha affects the indriya (sensory and motor organs) and leads to affliction of either side of the body. It also causes the desiccation of siras (nerves) and snayus (tendons), producing contractions of legs and hands on either side. [Cha.Sa. Chikitsa Sthana 28/43-45]
Pathogenesis
The vata dosha is aggravated due to two possible pathologies:
1. Depletion of body constituents (dhatu kshaya)
2. Obstruction or covering of vata dosha by other dosha or body constituents (dhatu, mala)
These two causes provide a background for pathogenesis of vata dominant diseases.
The aggravated vata is lodged in vacant spaces or afflicted channels (sroto vaigunya). Due to obstruction in its path or impaired movement, vata dosha affects the indriya (sensory and motor organs) and leads to affliction of either side of the body. It also causes the desiccation of siras (nerves) and snayus (tendons), producing contractions of legs and hands on either side. [Cha.Sa. Chikitsa Sthana 28/43-45]
The different pathologies like arteriosclerosis, aneurysms, and plaque formation in cerebrovascular system need to be understood in this view. These pathologies result in cerebrovascular accident, causing hemiplegia or hemiparesis (pakshaghata). [A. Hri.Nidana Sthana 15/5-6][1]
- ↑ 1.0 1.1 Vagbhata. Ashtanga Hridayam. Edited by Harishastri Paradkar Vaidya. 1st ed. Varanasi: Krishnadas Academy; 2000.
- ↑ Sushruta. Sushruta Samhita. Edited by Jadavaji Trikamji Aacharya. 8th ed. Varanasi: Chaukhambha Orientalia;2005.
- ↑ Madhavakara. Madhava Nidanam (Roga vinischaya). Translated from Sanskrit by K. R. Srikantha Murthy. 8th ed. Varanasi: Chaukhambha orientalia;2007