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→Six stages of pathogenesis of epilepsy (shatkriyakala for apasmara)
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.
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 ====
There are four types of apasmara depending upon the predominance of dosha as shown in fig. 5. The first thing of significance is that all these are sharira doshas and not manasa doshas. This implies that apasmara is predominantly a somatic disease in which psychological factors play a role in pathogenesis. The important aspect of management should be focused at the somatic level supported by psychotherapy. The role of genetic constitution is important in the study of clinical manifestations of apasmara as well as their response either to treatments involving allopathic anti-epileptic medications or to Ayurvedic treatment modalities. The diagnosis of dominance of dosha is also important in deciding the treatment modalities prescribed in cases of apasmara. The epigenetic variation of the four types of apasmara and the categorization of etio-pathological factors to lead the epigenetic modification resulting into specific type of Apasmara is worthy of study.
There are four types of apasmara depending upon the predominance of dosha as shown in fig. 5. The first thing of significance is that all these are sharira doshas and not manasa doshas. This implies that apasmara is predominantly a somatic disease in which psychological factors play a role in pathogenesis. The important aspect of management should be focused at the somatic level supported by psychotherapy. The role of genetic constitution is important in the study of clinical manifestations of apasmara as well as their response either to treatments involving allopathic anti-epileptic medications or to Ayurvedic treatment modalities. The diagnosis of dominance of dosha is also important in deciding the treatment modalities prescribed in cases of apasmara. The epigenetic variation of the four types of apasmara and the categorization of etio-pathological factors to lead the epigenetic modification resulting into specific type of Apasmara is worthy of study.
The table 1 depicts the premonitory signs of apasmara described in the Ayurvedic texts. Each sign has a specific patho-physiology in terms of dosha and dushya behind its manifestation. The enlisted signs are the alerting signals or premonitory symptoms of apasmara before the onset of seizures. The probable system involved as per conventional medicine is also enlisted for every sign, so that it would be easier to consider the pathophysiological similarities and differences between the two medical streams.
The table 1 depicts the premonitory signs of apasmara described in the Ayurvedic texts. Each sign has a specific patho-physiology in terms of dosha and dushya behind its manifestation. The enlisted signs are the alerting signals or premonitory symptoms of apasmara before the onset of seizures. The probable system involved as per conventional medicine is also enlisted for every sign, so that it would be easier to consider the pathophysiological similarities and differences between the two medical streams.
Table 1: Premonitory signs of apasmara and interpretation of mechanism
Table 1: Premonitory signs of apasmara and interpretation of mechanism
Pūrvarūpā Translation Dosha Dushya System involved
Pūrvarūpā Translation Dosha Dushya System involved
3. Enlisting newly introduced disease commonly observed in society into the umbrella of Apasmara e.g. Alzheimer’s dementia, depression etc.
3. Enlisting newly introduced disease commonly observed in society into the umbrella of Apasmara e.g. Alzheimer’s dementia, depression etc.
4. Retrospective analyses of all signs and symptoms enlisted in the modern text books and formulating probable samprapti / pathophysiology (dosha-dushya sammurchchna) based on dosha dominance behind manifestation of each sign and symptom can be formulated for better understanding in Ayurvedic perspective.
4. Retrospective analyses of all signs and symptoms enlisted in the modern text books and formulating probable samprapti / pathophysiology (dosha-dushya sammurchchna) based on dosha dominance behind manifestation of each sign and symptom can be formulated for better understanding in Ayurvedic perspective.
5. Assessment criteria in Ayurveda and modern science, modern investigation methods and technologies, biomarkers which are well established may be enlisted.
5. Assessment criteria in Ayurveda and modern science, modern investigation methods and technologies, biomarkers which are well established may be enlisted.
=== Further reading ===
=== Further reading ===