Changes

In conventional medicine, epilepsy in children is described in detail. However, the etiology of some variants of epilepsy is mentioned to be idiopathic. As described in context of ''skanda'' and ''skandapasmara'', the involvement of supernatural powers in causing ''apasmara'' is a matter of debate and falls in the purview of theology. Considering its importance and prevalence, ''apasmara'' of unknown etiology can be categorized as of the fifth type i.e. ''agantu apasmara''. Sushruta and his commentator Dallhana support this view that any variant of the disease which occurs without any reason, acutely and without any rational pathology shall be considered as ''agantu''. Per Charaka [Chikitsa 10/53], the etiopathology, clinical features and management of this fifth type are on the lines of ''agantu unmada''. As commented by Chakrapani, in case of ''agantu'' or ''bhutapasmara'', the etiology of being seized by some external factors is considered primary and the involvement (''anubabdha'') of ''dosha'' as secondary. It is important to note here that since clinical patho-physiology cannot take place without the involvement of ''doshas'', therefore ''agantu'' should technically be considered as one of the four doshic variants of ''apasmara'' mentioned earlier, in order to follow the ''sankhya niyam''a i.e. rules of numeral classification.  

In conventional medicine, epilepsy in children is described in detail. However, the etiology of some variants of epilepsy is mentioned to be idiopathic. As described in context of ''skanda'' and ''skandapasmara'', the involvement of supernatural powers in causing ''apasmara'' is a matter of debate and falls in the purview of theology. Considering its importance and prevalence, ''apasmara'' of unknown etiology can be categorized as of the fifth type i.e. ''agantu apasmara''. Sushruta and his commentator Dallhana support this view that any variant of the disease which occurs without any reason, acutely and without any rational pathology shall be considered as ''agantu''. Per Charaka [Chikitsa 10/53], the etiopathology, clinical features and management of this fifth type are on the lines of ''agantu unmada''. As commented by Chakrapani, in case of ''agantu'' or ''bhutapasmara'', the etiology of being seized by some external factors is considered primary and the involvement (''anubabdha'') of ''dosha'' as secondary. It is important to note here that since clinical patho-physiology cannot take place without the involvement of ''doshas'', therefore ''agantu'' should technically be considered as one of the four doshic variants of ''apasmara'' mentioned earlier, in order to follow the ''sankhya niyam''a i.e. rules of numeral classification.  

Premonitory signs of apasmara:

==== Premonitory signs of ''apasmara'' ====

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   

Patanadini falling etc. rasa-rakta,

Patanadini falling etc. rasa-rakta,

majja

majja

The abovementioned pre-clinical features are observed in the fourth stage of shatkriyakala (pathogenesis). These may be considered as aura in apasmara patients. These are important in view of prevention of apasmara progression to epileptic seizure. In conventional medicine text books, some of the above signs like auditory and visual hallucinations are referred. These signs need to be searched upon for their prevalence, categorization as per dosha dominance, involvement of dosha attributes in order to establish precise guidelines for early prevention and management of disease.     

The abovementioned pre-clinical features are observed in the fourth stage of shatkriyakala (pathogenesis). These may be considered as aura in apasmara patients. These are important in view of prevention of apasmara progression to epileptic seizure. In conventional medicine text books, some of the above signs like auditory and visual hallucinations are referred. These signs need to be searched upon for their prevalence, categorization as per dosha dominance, involvement of dosha attributes in order to establish precise guidelines for early prevention and management of disease.