PARALYSIS- A COLLABORATION OF AYURVEDIC AND MODERN

Created By: Siddhendu Bhattacharjee (Reg: 11004022) Sampriti Jana (Reg: 11106231)

INTRODUCTION: Paralysis is loss of muscle function for one or more muscles. Paralysis can be accompanied by a loss of feeling (sensory loss) in the affected area if there is sensory damage as well as motor. A study conducted by the Christopher & Dana Reeve Foundation, suggests that about 1 in 50 people have been diagnosed with paralysis. [1] Paralysis is a medical condition characterized by the inability to move one or more muscles. In most cases, a person experiencing this condition also loses all feeling in the affected area. It may be temporary or permanent, depending on the cause. If it is the result of damage to the nervous system, it is usually consistent. Sleep paralysis, on the other hand, only affects a person during the time that immediately precedes sleep or immediately after waking up. There are many potential causes of paralysis. The two most common are stroke and trauma, particularly to the nervous system or the brain. Certain diseases or afflictions, such as poliomyelitis, peroneal dystrophy, spin bifida, Bells palsy, and multiple sclerosis may also cause paralysis. Botulism, paralytic shellfish poisoning, and certain types of poisons, particularly those that directly affect the nervous system, may also lead to this condition. The precise type of paralysis a person experiences depends on the underlying cause. With Bells palsy, for example, the inability to move is usually localized, which means it only affects a small area of the persons body. Typically, only one side of the persons face becomes paralyzed as the facial nerve on that side becomes inflamed. When only one side of a persons body is affected, the condition is considered unilateral. When it affects both sides, it isobilateral. {2}

DEFINITION: 1. Complete or partial loss of function especially when involving the motion or sensation in a part of the body 2: Loss of the ability to move 3: A state of powerlessness or incapacity to act.

EXAMPLES OF PARALYSIS 1. The disease causes a paralysis of the legs. 2. The whole country is in a state of paralysis. 3. They are trying to end the political paralysis that has been gripping the country. ORIGIN OF PARALYSIS Latin, from Greek, from paralyein to loosen, disables frompara- + lyein to loosen First Known Use: 1525 OTHER MEDICINE TERMS analgesia, angina, diabetes, hepatitis, homeopathy,logorrhea, palliate, pandemic In Ayurveda it is known as Pakshaghat.

CAUSES AND SYMPTOMS Causes Paralysis is most often caused by damage to the nervous system or brain, especially the spinal cord. Major causes are Stroke, Trauma, Poliomyelitis, Amyotrophic Lateral Sclerosis (ALS), Botulism, Spina Bifida, Multiple Sclerosis etc. Paralysis may be localized, or generalized, or it may follow a certain pattern. For example, localized paralysis occurs in Bell's palsy where one side of the face may be paralyzed due to inflammation of the facial nerve on that side. Patients with stroke may be weak throughout their body (Global Paralysis) or have Hemiplegia (weakness on one side of the body) or other patterns of paralysis depending on the area of damage in the brain. Other patterns of paralysis arise due to different lesions and their sequelae. For example, lower spinal cord damage from a severe back injury may result in Paraplegia, while an injury higher up on the spinal cord, such as a neck injury, can cause Quadriplegia. Patients with paraplegia or quadriplegia often use equipment such as a wheelchair or standing frame for mobility and to regain some independence. The nerve damage that causes paralysis may be in the brain or spinal cord (the central nervous system) or it may be in the nerves outside the spinal cord (the peripheral nervous system). The most common causes of damage to the brain are:

stroke tumor trauma (caused by a fall or a blow) Multiple sclerosis (a disease that destroys the protective sheath covering nerve cells) cerebral palsy (a condition caused by a defect or injury to the brain that occurs at or shortly after birth) metabolic disorder (a disorder that interferes with the body's ability to maintain itself)

Damage to the spinal cord is most often caused by trauma, such as a fall or a car crash. Other conditions that may damage nerves within or immediately adjacent to the spine include:
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tumor herniated disk (also called a ruptured or slipped disk) spondylosis (a disease that causes stiffness in the joints of the spine) rheumatoid arthritis of the spine neurodegenerative disease (a disease that damages nerve cells) multiple sclerosis

Damage to peripheral nerves may be caused by:

trauma compression or entrapment (such as carpal tunnel syndrome) Guillain-Barr syndrome (a disease of the nerves that sometimes follows fever caused by a viral infection or immunization) chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) (a condition that causes pain and swelling in the protective sheath covering nerve cells) radiation inherited demyelinating disease (a condition that destroys the protective sheath around the nerve cell) toxins or poisons

Diagram : 1

Symptoms The distribution of paralysis offers important clues to the site of nerve damage. Hemiplegia is almost always caused by brain damage on the side opposite the paralysis, often from a stroke. Paraplegia occurs after injury to the lower spinal cord, and quadriplegia occurs after damage to the upper spinal cord at the level of the shoulders or higher (the nerves controlling the arms leave the spine at that level). Diplegia usually indicates brain damage, most often from cerebral palsy. Monoplegia may be caused by isolated damage to either the central or the peripheral nervous system. Weakness or paralysis that occurs only in the arms and legs may indicate demyelinating disease. Fluctuating symptoms in different parts of the body may be caused by multiple sclerosis. Sudden paralysis is most often caused by injury or stroke. Spreading paralysis may indicate degenerative disease, inflammatory disease such as Guillain-Barr syndrome or CIDP, metabolic disorders, or inherited demyelinating disease. Other symptoms often accompany paralysis from any cause. These symptoms may include numbness and tingling, pain, changes in vision, difficulties with speech, or problems with balance. Spinal cord injury often causes loss of function in the bladder, bowel, and sexual organs. High spinal cord injuries may cause difficulties in breathing. [5] TYPES OF PARALYSIS Quadriplegia (Tetraplegia) Paraplegia. [6]

DIAGNOSIS Careful attention should be paid to any events in the patient's history that might reveal the cause of the paralysis. The examiner should look for incidents such as falls or other traumas, exposure to toxins, recent infections or surgery, unexplained headache, preexisting metabolic disease, and family history of weakness or other neurologic conditions. A neurologic examination tests strength, reflexes, and sensation in the affected area and normal areas.

Imaging studies, including computed tomography scans (CT scans), magnetic resonance imaging (MRI) scans, ormyelography may reveal the site of the injury. Electromyography and nerve conduction velocity tests are performed to test the function of the muscles and peripheral nerves.

TREATMENT The only treatment for paralysis is to treat its underlying cause. The loss of function caused by long-term paralysis can be treated through a comprehensive rehabilitation program. Rehabilitation includes:

Physical therapy. The physical therapist focuses on mobility. Physical therapy helps develop strategies to compensate for paralysis by using those muscles that still have normal function, helps maintain and build any strength and control that remain in the affected muscles, and helps maintain range of motion in the affected limbs to prevent muscles from shortening (contracture) and becoming deformed. If nerve regrowth is expected, physical therapy is used to retrain affected limbs during recovery. A physical therapist also suggests adaptive equipment such as braces, canes, or wheelchairs. Occupational therapy. The occupational therapist focuses on daily activities such as eating and bathing. Occupational therapy develops special tools and techniques that permit self-care and suggests ways to modify the home and workplace so that a patient with normal people has no differences. Impairment may live a normal life.

Other specialties. The nature of the impairment may mean that the patient needs the services of a respiratory therapist, vocational rehabilitation counselor, social worker, speech-language pathologist, nutritionist, special education teacher, recreation therapist, or clinical psychologist.

PROGNOSIS The likelihood of recovery from paralysis depends on what is causing it and how much damage has been done to the nervous system.

PREVENTION Prevention of paralysis depends on prevention of the underlying causes. Risk of stroke can be reduced by controlling high blood pressure and cholesterol levels. Seatbelts, air bags, and helmets reduce the risk of injury from motor vehicle accidents and falls. Good prenatal care can help prevent premature birth, which is a common cause of cerebral palsy. [3] [6] FREQUENCY OF ATTACK IN SLEEP PARALYSIS:

Table: 1

PERIODIC PARALYSIS: Periodic paralysis is a disorder of skeletal muscle in which patients experience attacks of muscle weakness of variable duration and severity. The attacks can last from a few minutes to several days. The weakness in an attack can be generalized or focal. Early in the natural history of the disease muscle strength returns to normal after an attack, but later significant fixed muscle weakness often develops. The variability of the symptoms often leads to delays in accurate diagnosis and treatment.7 Causes: Periodic paralysis is a congenital condition, meaning it is present from birth. Familial periodic paralysis is inherited, but may occur without a known family history. Periodic paralysis is caused by abnormalities of the electrolyte channels on muscles. The inherited form of the disorder is autosomal dominant, which means that only one affected parent is needed to transmit the gene to the baby. When one parent is affected, the child has a 50% chance of getting the disease. Rarely, the condition occurs as a result of a noninherited genetic defect.9
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Genetic material

SLEEP PARALYSIS: Sleep paralysis is a feeling of being conscious but unable to move. It occurs when a person passes between stages of wakefulness and sleep. During these transitions, you may be unable to move or speak for a few seconds up to a few minutes. Some people may also feel pressure or a sense of choking. Sleep paralysis may accompany other sleep disorders such as narcolepsy. Narcolepsy is an overpowering need to sleep caused by a problem with the brain's ability to regulate sleep. Sleep paralysis usually occurs at one of two times. If it occurs while you are falling asleep, it's called hypnologic or predormital sleep paralysis. If it happens as you are waking up, it's called hypnopompic or postdormital sleep paralysis.8 PARALYSIS ACCORDING TO AYURVEDA: It has been discussed in Vata Vyadhi Prakaranam. It is known to be a complicated, as Prana Vatham & Marma (Pressure Points) are involved. Vata involvement is a major factor for its complications. The Modern Life styles, Dietary Habits, Lack of Proper Exercises, Injudicious ways of Physical Activities and Mental Stress and Strain are said to have a definite role in the Occurrences of PAKSHAGHAT. The general Pathology described for Vata rogs are Dhathukshaya (Nutritional Deficiencies) and Margavarodham (Obstruction in the Pathways). In Pakshaghata both the above factors have a definite role in the pathogenesis.
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The Line of Treatment is as follows: Swedanam Sneha Samyuktham Pakshaghate Virechanam!! (Ca. Chi) Swedanam (Suddation), Snehanam (Oleation) and Virecanam (Purgation) are the main modalities of treating Pakshaghata Patient. The other Panchakarma Procedures like Nasyam (Nasal Effusion), Vasthi Karma (Medicated Enema Procedures), Siro Vasthi, Kerala Procedures like: Elakizhi (Leaf Bundle Massage), Navarakizhi (Shali Shastika Pinda Swedam), Pizhichil (Sarvanga Dhara),Siro Dhara (Pouring of Oil on the Head) etc are done according to the patients requirement and severity.Brumhana Chikitsa, Vata hara Chikitsa and Marma Chikitsa are indicated. Now days the Panchakarma, the unique method of Purification is getting worldwide attension as a therapeutic measure, especially in chronic clinical conditions in which no complete cure is available in modern medical system. Researched Internal Medicines are usually prescribed along with Diet and Life style Modifications. A Vata pacifying diet and proper dietary habit are essential for long-term success. Additional Vata pacifying regimens including daily oil massage and Sensory Therapies complete the treatment. Meditation, Yogic practices, Pranayama, The Breathing Exercises is to be done on a regular and daily basis to overcome the stress and the disease. One should follow Achara Rasayana (The Art of being the Best of Soul) like being Sathwik, following elders advise, keeping and controlling the hard feelings, controlling the mental urges etc. 9

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REFERENCES:
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http://www.christopherreeve.org/site/c.mtKZKgMWKwG/b.5184189/k.558 7/Paralysis_Facts__Figures.htm http://www.merriam-webster.com/dictionary/paralysis http://medical-dictionary.thefreedictionary.com/paralysis http://www.thefreedictionary.com/paralysis http://www.localhealth.com/article/paralysis-symptoms http://www.apparelyzed.com/paralysis.html Doreen fialho. Michael G. HANNA*Periodic Paralysis: Hand Book of clinical neurology. Vol-86. http://www.webmd.com/sleep-disorders/guide/sleep-paralysis http://www.ayursages.com/paralysis.html

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