Administrators, Editors, Bots, Bureaucrats, Charaksamhita, Moderators (CommentStreams), Interface administrators, Administrators
10,109
edits
Changes
Jump to navigation
Jump to search
Line 1,900:
Line 1,900: + + + + + + + + + + + + + + + + + + + + + + + − * [[Apasmara Nidana]]+
→Related Chapter
| ''Apasmara''
| ''Apasmara''
|}
|}
==Researches on Apasmara==
=== Apasmara (epilepsy) and its management with maha-panchagavya ghrita===
In a clinical study, maha panchagavya ghrita was given orally in a dose of 10 gms two times a day in first group (group A) of patients diagnosed with apasmara (epilepsy). In other group B, 3 gm of vachadi vati was given three times in a day with water in control group. The patients were enrolled and randomly categorized into two groups. The results of group A showed significant relief in the ictal features and post-ictal features of amnesia (61.3%) and drowsiness (50%). The frequency of attacks was significantly reduced from average of 1.75 times/week to 0.96 time/week. The overall effect showed that 25% patients had complete remission in group A. In the group B, significant relief was obtained in each of the pre-ictal features of loss of [[sleep]]. Relief in total post-ictal features (55.6%) was also significant. During follow up, the frequency of attacks was reduced to 50% in 33% of the patients, to 25% in 41.7% of the patients of group B. The above results imply that the maha panchagavya ghrita was comparatively better on the main clinical event, i.e., the ictal stage, and on the frequency, duration, and severity of attacks. It was more effective in maintaining the seizure threshold.<ref>Usha K. S. (2001). A clinical study on apasmara (epilepsy) and its management with Maha-Panchagavya Ghrita. Department of Kayachikitsa. IPGT & RA, Jamnagar.</ref>
=== Review of kushmanda ghrita in the management of Generalized Tonic-Clonic Seizures (GTCS)===
Kushmanda ghrita is mentioned in Ashtanga Hridaya for the management of Epilepsy (Apasmara). It is one of the best anti-epileptics (apasmarahara) drug consisting of mainly three drugs such as [[kushmanda]] (Benincasa hispida), [[yashtimadhu]] (Glycyrrhiza glabra L.) and cow’s ghee (go-ghrita). It possesses digestive stimulant, anti-convulsant, strength promoting, and [[memory]] enhancing properties. Antiepileptic drugs appear to act primarily by blocking the initiation or spread of seizures. This occurs through a variety of mechanisms that modify the activity of ion channels or neurotransmitters. Experimental studies have proven that [[kushmanda]] swarasa (fruit extract) has antioxidant activity on the human brain. Vitamin–B present in [[kushmanda]] has a direct impact on energy levels, brain functioning, and cell metabolism. It also reduces fatigue and boosts mood. The seeds of Benincasa hispida (Thunb.) Cogn. is enriched with GABA and helps in seizure control action. The antioxidant and neuroprotective effect root of [[yashtimadhu]] protects susceptible brain cells from oxidative stress, resulting in reduced brain damage and improved neuronal function with improvement in memory. The ketone bodies, β- hydroxybutyrate, aceto-acetate, and acetone are synthesized and are able to cross the blood-brain barrier to provide an alternative source of energy for the brain. Compared to the conventional AEDs, a similar action can be obtained through this synergism in [[Kushmanda]] ghrita. [[Kushmanda]] Ghrita is a unique combination that can be practiced in chronic cases of GTCS and acts as a rasayana. Ghee preparations are considered the foremost medium for delivering the active principles in neurological conditions affecting the brain because of their ability to cross the blood-brain barrier. Ghee is a good processing medium since it will carry the active principles of the processed drugs to the target tissue, also it will act as medicine by itself with its innate property called ‘yogavahi’. Ghee obtained from cow’s milk consists of short-chain and medium-chain fatty acids. Ketone bodies produced as a secondary metabolite from fat metabolism are proven to have anticonvulsant activity. As all three drugs present in kushmanda ghrita are [[memory]] boosting (medhya) and kushmanda act as alleviates diseases of brain (cheto-vikaranashaka). The GABA rich property of kushmanda, Na+ K+ channel inhibition property of yashtimadhu, and the ketogenic effect of ghrita act as a perfect trio in generalized tonic-clonic seizure management and thereby highlighting its uniqueness.<ref>Krishna Priya G., Vijay Bhaskar S. A Critical Review of Kushmanda ghrita in the management of Generalized Tonic-Clonic Seizures. International Journal of Advanced Research (IJAR). 2022; 10 (07), 479-483.</ref>
===Ayurvedic management of apasmara w.s.r. to epilepsy- A Case Report===
This study is regarding a case report of a 17-year-old male patient having ‘apasmara’ (epilepsy) came with symptoms such as mental irritation, disturbed sleep, mental impairment (dhee), grasping (dhriti), and memory (smriti). Previously, the patient used to get 2- 3 seizure attacks per day, which gradually increased in 10 years. The patient also complained of frequent jerking movements of both arms and neck, and loss of [[consciousness]] during attack. For treatment, both purificatory therapy ([[shodhana]]) and palliative therapy (shamana) was planned. For [[shodhana]], medicated enema ([[matra basti]]) with 120 ml narayana oil for 20 days, nasal instillation of medicated drugs in powder form (pradhaman [[nasya]]) with [[vacha]] (Acorus calamus Linn.) and [[shunthi]] (Zingiber officinale) powder, twice a day for 20 days. For shamana, oral administration of different formulations was given such as juice of benincasa hispida ([[kushmanda]] swarasa) with [[yashtimadhu]] churna (Glycyrrhiza glabra) - 40 ml × twice a day for 8 days, further combination of smrutisagara rasa + juice of Centella asiatica ([[mandukaparni]] rasa) with honey- 500 mg, twice a day for 8 days, combination of chaturbhuja rasa + smrutisagara rasa + [[bramhi]] vati + saraswata vati with mahakalyanaka ghruta- 500 mg, twice a day for 30 days and raupya suvarna sutshekhara rasa 250 mg, twice a day for 30 days. In this case study, the treatment included ayurvedic medications, bio-purification ([[panchakarma]]) and [[shamana]] with yoga, pranayama, and asana. [[Panchakarma]] and internal ayurveda medicines work surprisingly with remarkable improvement in this patient. Shamana treatment along with pradhmana [[nasya]], and [[matra basti]], are observed safe without any interactions and adverse effects in the treatment in apasmara in this case study.<ref>Srajan Madhur Jain, Harish Garge, Shripad Upasani et al. Ayurvedic management of Apasmara w. s. r. to epilepsy - a case report. Ayurlog: National Journal of Research in Ayurved Science- 2021; (09) (04): 01-06. </ref>
===Therapeutic potential of [[ayurveda]] treatment ([[panchakarma]] and herbal medicine) in epilepsy in children ===
This case study is reported on a child suffering from epilepsy for the last 12 years. The first episode of seizure developed at age 1 year and 6 months, since then anti-epileptic medicines were started. Treatment modalities adopted for this case are as follows; digestive power stimulant and digestant ([[deepana]]-[[pachana]]) with chitrakadi vati- 1 BD before meal and avipattikar powder- 1 tsf with warm water at night for 1 day only. Further whole body massage (sarvanga [[snehana]]) by bala oil and whole body sudation (sarvanga [[swedana]]) and medicated unctuous enema ([[matra basti]]) for 7 days by 20 ml of kalyanaka ghrita was given. Small amount of [[vacha]] (acorus calamus) was added with kalyanaka ghrita for [[matra basti]]. Afterwards internal medicines such as dhandhanyadi decoction (kashaya) TID orally and brihatvata-chintamani rasa-1 tab.BD and siddharthaka tablet-1 tab BD. Previous ongoing allopathic medicine Epilex (Sodium Valproate) 200mg 1 tsp BD after meal for 30 days, then syp. epilex were stopped. Above treatment was again repeated with gap of 15 days and oral medication are continued for 2 months. In short for 2 Months this treatment was done i.e., 4 times with 15 days follow up. [[Deepana]]- [[pachana]] was given to control the formation of [[ama]] in the initial stage, which is very important in preventing the manifestation of the disease. Acharya Charak has mentioned bio-purification ([[shodhana]]) as a line of treatment, so in this case study [[matra basti]] with kalyanaka ghrita and shiroabhyanga with [[bramhi]] ghrita chikitsa has been chosen. They showed good results. Special scoring pattern were made to assess the efficacy of treatment, the details of which are as follows; the severity of attack and duration of convulsion reduced from score 2 before treatment to score zero i.e., complete relief in symptoms of epilepsy. The frequency of convulsion and ictal features were reduced from score 1 before treatment to score zero i.e., complete relief in symptoms of epilepsy. It means panchakarma treatment and internal ayurvedic medicine were given and proves to be effective in the management of apasmara and to improve the quality of life of the affected children. This treatment modality found to be significantly effective in this case of paediatric epilepsy and patient got relief. <ref>Lowkesh Chandravanshi, Aparna Singh. Therapeutic potential of Ayurvedic Treatment (Panchkarma and Herbal Medicine) in Pediatric Epilepsy: A Case Report. International Journal of Health and Rehabilitation Sciences. Volume 7, Issue 3, Sep. 2018; 155-160. </ref>
===Efficacy of Shatavari taila [[nasya]] and internal administration of [[brahmi]] ghrita in the management of apasmara===
Apasmara (epilepsy) is a disease affecting the higher center, i.e., the brain, so just oral administration is not possible to get the desired result. So, management of this disorder should be done through various modalities and routes of drug administration. One such non-oral route is [[nasya]] i.e., that is administering of powdered or liquid medicament into the nostrils. [[Shatavari]] (Asparagus Racemosus) oil was selected for this study which has different herbs like seeds of [[eranda]] (Ricinus communis), [[ashwagandha]] (Withania somnifera), and ksheeravidari kanda (Prureria tuberosa). All these are indicated in management of apasmara. The ingredients of [[brahmi]] ghrita are [[brahmi]] (Bacopa monieri), [[vacha]] (Acorus calamus), [[kushtha]] (Saussurea lappa), [[shankhapushpi]] (Convolulus pluricaulis) and age old ghee (purana ghrita). These herbs are also individually proven better in internal medication (shamana aushadhi).
Total 34 diagnosed patients of apasmara fulfilling the inclusion criteria and willing to register for study were enrolled for this study for the duration of 2 months. Assessment was done before and after the study period the clinical features of epilepsy by International League against Epilepsy (ILAE), patients were screened and selected according to the diagnostic criteria and a single group study was conducted. They were administered [[nasya]] with [[shatavari]] taila for seven days and later subjected to [[shamana]] therapy by [[brahmi]] ghrita. The patients were analysed after nasya at the end of seven days and later on every consecutive 15th day, for a period of two months. Frequency of the attacks were reduced after seven days of [[nasya]]. Consequently, improvements were observed in the complaints of loss of consciousness, where 93.3% reported them before treatment and after [[nasya]] it was found to be just 3.3% of the patient and later after the [[shamana]] treatment, it was found to have reduced in 76% of the patient. Convulsive movements were reported by 96% of the patient, which at the end of total therapy was found to reduce to 16.7%. Fall, epileptic cry, frothing from mouth and chattering of teeth were significantly (p < 0.001) reduced by the end of follow up period of 2 months. Similar observations were made in case of duration and severity of attacks. Epilepsy (apasmara) is an extensively researched disease and its management has just reached a stage where only seizures can be controlled. Some difficulties arise, in terms of the route of drug administration during the active state of convulsion where the conventional routes are difficult to access or inaccessible. Hence in this study, an easier route of administration i.e., nasal route was explored, for providing management with better outcome, for epilepsy. <ref>Sharmitesh R Tripathi, Savitha HP, Suhas Kumar Shetty. Efficacy of Shatavari taila Nasya and Brahmi gritha in the management of Apasmara. J Pharm Sci Innov. 2016;5(6), 181-18.</ref>
=== Related Chapter ===
=== Related Chapter ===
[[Apasmara Nidana]],[[Manas]], [[Aatma]], [[Smriti]], [[Indriya]], [[Psychiatric diseases]], [[Neurological diseases]]
<big>'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''</big>
<big>'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''</big>