“Ayurvedic Management of Pakshaghata (Recurrent Cerebrovascular Accident): A Case Study”

Abstract

Stroke or Cerebrovascular Accident (CVA) is characterized by sudden, localized neurological deficit caused by disturbance in the cerebral vasculature, and remains one of the leading causes of death and disability in India, particularly in patients with longstanding, poorly-controlled hypertension. Ayurveda describes such unilateral motor and sensory impairment as Pakshaghata, a Vata-predominant Vatavyadhi affecting the Sira, Snayu and Kandara of one half of the body. Recurrent stroke in an already hemiparetic, hypertensive patient carries a particularly high burden of residual disability, and integrative documentation of such cases can help guide clinical decision-making. Material and Methods: A 49-year-old male with an 11-year history of poorly-compliant hypertension and a first right-sided CVA in 2015 presented with a second right-sided CVA of 10 days’ duration, with right hemiparesis, gait difficulty, slurred speech, difficulty rising from sitting and insomnia. MRI brain showed an acute non-haemorrhagic infarct in the left corona radiata superimposed on chronic small-vessel ischaemic change, old right occipital gliosis and diffuse cerebral atrophy; 2D-echocardiography showed hypertensive heart disease with concentric left ventricular hypertrophy. The patient was admitted for 15 days and managed with Shaman (oral) Ayurvedic formulations along with Snehana, Nadi Sweda, an 8-day Yoga Basti regimen followed by continued Basti, Nasya, Sahastishali Pinda Sweda and physiotherapy. Observation and Result: At discharge, muscle power in the right upper limb improved from 3/5 to 5/5 and in the right lower limb from 3/5 to 5/5 (MRC scale), with a corresponding increase in deep tendon reflex amplitude on the right side; gait, speech clarity and sleep also improved subjectively, though the right plantar response remained extensor throughout.