Paraplegia (Pangu)

Background

Paraplegia describes complete or incomplete paralysis affecting the legs and possibly also the trunk, but not the arms. It is impairment in motor or sensory function of the lower extremities. It is usually caused by spinal cord injury or a congenital condition such as spina bifida that affects the neural elements of the spinal canal. The area of the spinal canal that is affected in paraplegia is either the thoracic, lumbar, or sacral regions. The extent to which the trunk is affected depends on the level of spinal cord injury. Paraplegia is the result of damage to the cord at the level of T1 and below.

Paralysis or weakness of both lower limbs occurs in Pangu. It is Vata predominant disease and limping movement (Vikalagati) is the literal meaning of Pangu, where both the lower limbs are involved. Specific Nidana of Pangu has not been mentioned, because it is mentioned as one of the disorder of vitiated Vayu. Hence the factors, which are responsible for the vitiation of Vayu can be considered as the Nidana of Pangu also.

Intervention/ Approaches

The following are some interventions/ approaches based on CCRAS research from published sources.

In case of changed muscle tone, diminished muscle power and disturbed urinary bladder and rectum functions:

• Ekangavira Rasa -125mg and 5- 10ml Eranda Taila along with milk thrice a day for 60 days.
• Abhayanga- 50ml Mahamasha Taila for 60 days.

Patients of Vata dosha predominance in pathogenesis:

• Snehapana -50ml Sahacharadi Tailam on first day and should be
• increased 50ml on consecutive days for 7 days or till Samyak
• Snigdha Lakshana.
• Swedana- Vashpasweda for 3 days.
• Virechana - 20-3 Oml Eranda Taila.
• Samsarjana Karma (for 2 days) - Should take light food (as gruel of green gram).
• Shamana Chikitsha
• Sahacharadi Tailam -1 Oml twice a day.
• Sahacharadi Kashaya - 60ml thrice a day.
• Sahacharadi Tailam - 20-40ml for abhyanga.
• All these Shamana Chikitsa should be given for next 5 days.
• Yogavasti - 5 Sneha Vasti and 3 Kashaya Vasti.
  • Sneha Vasti- 240ml of Sahacharadi Tailam on 1st 3rd, 5th, 7th and 8th day.
  • Kashaya vasti- on 2nd, 4th, 6th day with
    
    • Sahacharadi Tailam - 240ml
    • Shatapushpa (Anethum sowa) - 30 gm
    • Honey - 240ml
    • Sahacharadi Kashaya-480ml
    • Saindhava Lavana -15gm
• Shamana Chikitsa
• Sahacharadi Tailam-10 ml twice a day for next 34 days.
• Sahacharadi Kashaya - 60ml thrice a day for next 34 days.
• Sahacharadi Tailam - 20-40ml for abhayanga for next 34 days.

Patients of Vata-Pitta dosha predominance in pathogenesis, pain while walking, diminished muscles power and increased ESR:

• Gorochanadi Gutika - 250mg thrice a day along with milk for 60 days.
• Ashwagandha (Withania somnifera)Chuma - 4gm thrice a day along with milk for 60 days.
• Abhyanga - 40ml Balashwagandhalakshadi Taila every day for 60 days.

Patient having degenerative changes in nerves and chronic cases where muscles weakness is more prominent:4

• Snehapana - 5Oml Prabhanj ana Vimardanam Tailam on first day and
• should be increased 50ml on consecutive days for 7 days or till
• Samyak Snigdha Lakshna.
• Swedana - Vashpa Sweda for 3 days.
• Virechana - 20 to 30ml Eranda Taila.
• Yogavasti - 5 Sneha Vasti and 3 Kashaya Vasti.
  
  • Sneha Vasti- 240ml of Prabhanj ana Vimardanam Tailam on 1st’ 3rd, 5th, 7th and 8th day.
  • Kashayavasti on 2nd, 4th, 6th day with
    
    • Prabhanj an Vimardanam Tailam 240ml
    • Honey- 240ml
    • Kwatha-480ml
    • Satapushpa (Anethum sowa) - 30gm
    • SaindhavaLavana-15gm.

Medicinal Plants useful in Paraplegia (Pangu)

Source : Central Council for Research in Ayurvedic Sciences