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The grave disease ''atattvabhinivesha'' is considered as affliction of discrimination power of intellect leading to severe perversion of mental functions.  The pathophysiology includes affliction of mind and intellect simultaneously. Therefore this disease comprises disturbance of mind and intellectual functioning. Decisive and discriminative power of the afflicted person is completely lost. This leads to improper judgment regarding eternal and ephemeral events and wholesome and unwholesome objects. Coordination of mind, intellect, sense-motor organs is disturbed.
 
The grave disease ''atattvabhinivesha'' is considered as affliction of discrimination power of intellect leading to severe perversion of mental functions.  The pathophysiology includes affliction of mind and intellect simultaneously. Therefore this disease comprises disturbance of mind and intellectual functioning. Decisive and discriminative power of the afflicted person is completely lost. This leads to improper judgment regarding eternal and ephemeral events and wholesome and unwholesome objects. Coordination of mind, intellect, sense-motor organs is disturbed.
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==== Patho-physiology of atattvabhinivesha ====
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==== Patho-physiology of ''atattvabhinivesha'' ====
 
   
 
   
 
===== Differential diagnosis =====   
 
===== Differential diagnosis =====   
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The diseases with convulsive movements of the body and loss of memory can be considered for differential diagnosis for apasmara. Though apasmara is a manasa vikara, the diseases with presentation of kampa[tremors], gatra vikshepa [abnormal body movements], vepathu[trembling], etc in the form of paroxysms can be thought of for discussion under differential diagnosis. They include akshepaka (vata vyadhi), dandaka (stiffness), ardita (facial palsy or hemeparesis), apatanaka (status epilepticus), apatantraka (opisthotomus) and vepathu (kampavata/tremors).
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The diseases with convulsive movements of the body and loss of memory can be considered for differential diagnosis for ''apasmara''. Though ''apasmara'' is a ''manasa vikara'', the diseases with presentation of ''kampa''(tremors), ''gatra vikshepa'' (abnormal body movements), ''vepathu''(trembling), etc in the form of paroxysms can be thought of for discussion under differential diagnosis. They include ''akshepaka'' (''vata vyadhi''), ''dandaka'' (stiffness), ''ardita'' (facial palsy or hemeparesis), ''apatanaka'' (status epilepticus), ''apatantraka'' (opisthotomus) and ''vepathu'' (''kampavata'', or tremors).
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Akshepaka is explained as a vata vyadhi in Chikitsa sthana 28th chapter characterised by repeated convulsive movements of body when vitiated vata affects muscles and tendons of hands and legs. (Verses 51, 52)
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''Akshepaka'' is explained as a ''vata vyadhi'' in [[Chikitsa Sthana]] 28th chapter characterised by repeated convulsive movements of body when vitiated vata affects muscles and tendons of hands and legs. (Verses 51, 52)
 
Dandaka is denoted in the same context as stambha (stiffness) manifested in pani [hands], pada [legs], shira [head], prishtha [back] and shroni [pelvis] making body stiff like wooden log. (verse52)
 
Dandaka is denoted in the same context as stambha (stiffness) manifested in pani [hands], pada [legs], shira [head], prishtha [back] and shroni [pelvis] making body stiff like wooden log. (verse52)
 
Ardita caused when vayu does upashoshana [dries up] of bahu [arm] pada [leg] and janu [knees], is characterised by vakrata [curved] of mukhardha bhaga [half face] and also shareerardha [half body]. The attacks of ardita donot include convulsions as presenting feature. (Verses 38 to 42)
 
Ardita caused when vayu does upashoshana [dries up] of bahu [arm] pada [leg] and janu [knees], is characterised by vakrata [curved] of mukhardha bhaga [half face] and also shareerardha [half body]. The attacks of ardita donot include convulsions as presenting feature. (Verses 38 to 42)

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