INTERNATIONAL

AYURVEDIC
MEDICAL JOURNAL
Case Report ISSN: 2320 5091 Impact Factor: 4.018

AYURVEDIC INTERVENTION IN THE MANAGEMENT OF TRIGEMINAL

NEURALGIA w.s.r ANANTAVATA
ANANTAVATA: A CASE STUDY

Tumpa Brahma1, D.B. Vaghela2

1 rd
3 Year P.G Scholar, 2I/C HOD & Associate Professor,
Department of Shalakyatantra, IPGT & RA, GAU, Jamnagar, Gujarat, India

Email: tumpabrahmajbr@gmail.com

ABSTRACT
Trigeminal Neuralgia is considered as the most excruciating painful condition known to mankind. Due to sharp,
intense and stabbing nature of pain sufferers called it as ‘suicide disease.’ Even after the availability of newer
medicines along with surgical advancement
dvancement coupled with noval techniques, there is lack of promising results
against this ailment. Moreover, use of the drugs like anti depressants, anti convulsants and analgesics lead to vari-
var
ous side effects. The aim of the study is to evaluate the effec
effectt of Ayurvedic treatment in the management of Tri-
Tr
geminal Neuralgia. Ayurvedic classics mentioned this similar condition as Anantavata,, one of the Shiroroga
which is Vata Pradhana Sannipatik in nature. A 42 years old male patient visited OPD of Shalakyatantra, IPGT
& RA hospital on 25.07.2017 with complain
complaints of repeated unilateral sharp lancinating pain on right side of face
for brief duration and restricted jaw movement since 2 years. He consulted with a neurosurgeon and was advised
for surgery. But he did not want to undergo surgical intervention. Treatment was given with Nasya,
Karnapoorana , Nadisweda,
isweda, Shiropichu followed by Shamana Aushadhis like Aswagandhyyadi Ghreeta, Yogaraja
Guggul and Vatagajankusha Rasa.. Marked relief was found in symptoms after 1 month of treatment. The combi- comb
nation of therapy showed excellent result in reducing the recurre
recurrence
nce of pain. Ayurvedic treatment can prove to be
an effective alternative, a non invasive safe therapy in the management of Trigeminal Neuralgia.

Keywords: Trigeminal Neuralgia, Anantavata, Nasya, Karnapoorana, Shamana Aushadhi.

INTRODUCTION
Trigeminal Neuralgia (TN), also called tic although the actual figure may be significantly high-
hig
douloureux,, is a chronic pain condition that affects er due to frequent misdiagnosis.
the trigeminal or 5th cranial nerve, one of the most Trigeminalal Neuralgia is a neuropathic pain disorder
widely distributed nerves in the head. It is a common which exact cause is unknown. There are some in-
condition with an incidence of 5.7 per 10,000 wo wom- stances when the nerve can be compressed by nearby
en and 2.5 per 10,000 men. The most commonly blood vessels, aneurysms or tumors. Living with
70 year age group1,
affected subjects are in the 50-70 trigeminal neuralgia can be very difficult. It can
have a significant
ant impact on a person’s quality of
 Tumpa Brahma & D.B. Vaghela: Ayurvedic Intervention In The Management Of Trigeminal Neuralgia W.S.R Anantavata: A
Case Study

life, resulting in problems such as weight loss, isola- The present study is an attempt to evaluate the effi-
tion and depression2. cacy of Ayurvedic treatment modalities in the man-
The trigeminal nerve has three branches that con- agement of Trigeminal Neuralgia.
duct sensations from the upper, middle and lower
portions of the face, as well as oral cavity to the MATERIALS AND METHOD:
brain. The Ophthalmic or upper branch supplies sen- CASE HISTORY:
sation to the most of the scalp, forehead and front of A 42 years old male patient, shop keeper by profes-
the head. The maxillary or middle branch stimulates sion, has visited OPD of Shalakyatantra, IPGT &
the cheek, upper jaw, upper lip, teeth and gums and RA hospital on 25.07.2017 with complaints of recur-
to the side of the nose. The mandibular or lower rent electric shock like pain over right side of face
branch supplies nerves to the lower jaw, teeth and for last 2 years. According to patient, initially the
gums and lower lip. In Trigeminal Neuralgia (TN) sharp lancinating pain occurred two to three times in
one or more branches are affected and usually uni- a week which persists for 2-3 minutes. But gradually
lateral3. the duration and frequency both were increased.
The ‘typical’ or ‘classic’ form of the disorder (Type Now the patient also suffering from restricted jaw
1 or TN1) causes extreme, sporadic sudden burning movement for six months. The attacks of pain were
or shock like facial pain that lasts anywhere from a typically triggered during the time of chewing, shav-
few seconds to as long as two minutes per episode. ing, washing mouth and smiling and during night
The ‘atypical’ form of the disorder (Type 2 or TN time. His MRI of brain report showed superior
2), is characterized by constant aching, burning, cerebeller arteries impinging bilateral trigeminal
stabbing pain of somewhat lower intensity than Type nerves. Before attending the OPD of IPGT & RA
1. The pain is aggravated during shaving, washing Hospital, he consulted with a Neurosurgeon and was
face, brushing teeth, eating, chewing, talking or be- taking medicine for 2 years. But he did not get any
ing exposed to wind4. relief in signs and symptoms and gradually his con-
dition become worsen. At last, he was advised for
In Modern Science, Number of medicines used to surgery. But the patient was not willing to undergo
control the pain of Trigeminal Neuralgia like Car- surgery and visited this hospital for taking
bamazepine, Phenytoin, Gabapentine and Ayurvedic treatment.
Clonazipum. But prolong use of these drugs cause PERSONAL HISTORY:
side effects drowsiness, diplopia, nausea, ataxia etc. Diet-Vegetarian, Appetite- Moderate, Bowel– Regu-
Other treatment modalities are peripheral lar, Micturation: Normal, Sleep- Disturbed, fatigue
neurectomy, gasserian ganglion injection, intracrani- on awakening, Addiction- No.
al decompression of trigeminal ganglion etc. But
these treatment modalities show unsatisfactory re- INVESTIGATIONS:
sults against this ailment. Hb%-16.8 gm/dL, TC- 7600/cumm, ESR – 02mm/hr
In Ayurveda, Trigeminal Neuralgia can be correlated FBS- 87mg/dL, PPBS- 108mg/dL, S. Creat.-1.4
with Anantavata, one among the 11 types of mg/dL, S. Urea- 23 mg/dL
ShiroRoga having similar clinical presentations5.

TREATMENT:
Both Shodhana and Shamana Chikitsa were given to the patient.
Procedure Drugs used Duration Dosage
Nasya Brihat Dashamoola Taila 7 days 6 drops in each nostril

IAMJ: Volume 6, Issue 4, April, 2018 910

 Tumpa Brahma & D.B. Vaghela: Ayurvedic Intervention In The Management Of Trigeminal Neuralgia W.S.R Anantavata: A
Case Study

Karnapoorana Ksheer Bala Taila 21 days 15 drops in each ear

Shiropichu Bala Taila 15 days 10 ml BD
Nadisweda Rasnasaptaka Kwath 10 days 10 ml BD

INTERNAL MEDICATION: CONCLUSION

1. Amapachana Vati : 2 Pill BD after meal Proper Srotoshodhana and Doshanulomana thera-
2. Aswagandhyadi Ghreeta: 10 ml BD pies had shown significant improvement in relieving
Anupana: Luke warm water the condition. Study on a larger number of samples
3. Erandabhrista Haritaki: 10 gm at HS to draw more concrete conclusions. Awareness
4. Yogaraj Guggul: 2 pill BD should be created for the role of Ayurveda in such
Anupana: Luke warm water type of diseases especially concerned with Ayurveda
5. Vatagajankush Rasa: 2 pill BD where modern medicine has limited role.

RESULTS AND DISCUSSION REFERENCES

After one month of treatment, patient got relief in 1. Hall G C, Carroll D, Parry D, Mc Quay HJ. Epidemi-
intensity and duration of pain. Patient was followed ology and treatment of neuropathic pain. The UK
primary care perspective. Pain 2006;122:156-62
up for two months. During that period frequency of
2. Trigeminal neuralgia symptoms and causes- Mayo
pain was decreased. Jaw movement was 50% im-
clinic https: www.mayoclinic .org
proved after complete course of treatment. As per 3. Lange. Current Diagnosis and treatment in Otolaryn-
Ayurvedic classics, special Shiro Rogas like gology-Head and Neck Surgery. edited by Anil K.
Suryavarta, Ardhavabhedaka, Anantavata are main- Lalwani 3rd ed. Mc Graw Hill Companies; 38 pp.
ly Sannipataja disease. The symptoms like pain and 4. https://en.m.wikipedia.org
restricted jaw movement in Anantavata are correlat- 5. Susruta Susruta Samhita with Nibandhasangraha
ed with the symptoms of Trigeminal Neuralgia. Commentry of Sri Dalhanacharya and
Anantavata is considered as Vata pradhana Nyayachandrika Panjika of Sri Gayadasacharya.
Sannipatik disease. So, for the present study Uttartantra chapter 25/1. Edited by Yadavji Trikamji
Acharya. reprint ed. Varanasi. Chaukhamba
Vatashamaka treatment was given for reducing the
Surabharti Prakasana.654pp.
pain. Bhrihat Dashamoola Taila having Snigdha,
Guru Guna, Madhura, Lavana Rasa, Madhura
Vipaka ,Ushna Veerya which pacifies Vata Dosha
Source of Support: Nil
(main factor for all types of pain). Ksheerbala Taila Conflict Of Interest: None Declared
having Vatashamaka properties so pacifies pain and How to cite this URL: Tumpa Brahma & D.B. Vaghela:
inflammation. Karnapoorana by local Snehana ef- Ayurvedic Intervention In The Management Of Trigeminal
fect gives benefits of Rasayana and nourishes the Neuralgia W.S.R Anantavata: A Case Study. International
Ayurvedic Medical Journal {online} 2018 {cited April,
nervous tissues. Shiropichu with Bala Taila controls
2018} Available from:
vitiated Doshas in the head, soothes Marmas, im- http://www.iamj.in/posts/images/upload/909_911.pdf
prove blood supply and nutrition to brain, relaxes
and revitalizes the central nervous system.
Nadisweda having Srotosodhana and
Doshanulamana properties and also improves blood
circulation locally and reduces stiffness and pain.
Internal medicines posses Doshashamaka properties.

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