International Journal of Complementary & Alternative Medicine Review article Open Access Neurological conditions in Charaka Indriya Sthana - An explorative study Abstract Volume 13 Issue 3 - 2020 Ayurveda is a traditional Indian system of medicine and ‘Charaka samhita’ has been the Prasad Mamidi, Kshama Gupta most popular referral treatise for Ayurvedic academicians, clinicians and researchers all Dept of Kayachikitsa, SKS Ayurvedic Medical College & Hospital, over the world. ‘Indriya sthana’ is one among the 8 sections of ‘Charaka samhita’ and it India comprises of 12 chapters which deals with prognostication of life expectancy based on ‘Arishta lakshanas’ (fatal signs and symptoms which indicates imminent death). Arishta Correspondence: Prasad Mamidi, Dept of Kayachikitsa, SKS lakshanas are the fatal signs which manifests in a diseased person before death. Various Ayurvedic Medical College & Hospital, Mathura, Uttar Pradesh, neurological conditions are mentioned throughout ‘Charaka Indriya sthana’ in a scattered India, Tel 7567222856, Email way. The present study attempts to screen various references pertaining to neurological conditions of ‘Charaka Indriya sthana’ and explore their rationality, clinical significance Received: June 08, 2020 | Published: June 15, 2020 and prognostic importance in present era. Various references related to neurological conditions like, ‘Neuropathies’, ‘Neuro-ophthalmological disorders’, ‘Neurocognitive disorders’, ‘Neuromuscular disorders’, ‘Neurodegenerative disorders’, ‘Lower motor neuron syndromes’, ‘Movement disorders’ and ‘Demyelinating disorders’ are mentioned in ‘Charaka Indriya sthana’. The neurological conditions mentioned in ‘Charaka Indriya sthana’ are characterized by poor prognosis, irreversible pathology, progressive in nature and commonly found in dying patients or at the end-of-life stages. It seems that neurological conditions mentioned in ‘Charaka Indriya sthana’ have clinical applicability and prognostic significance in present era also. Further studies are required to substantiate the clinical findings mentioned in ‘Charaka Indriya sthana’. Keywords: demyelinating disorders, neurocognitive disorders, neurodegenerative disorders, neuromuscular disorders, neuro-ophthalmological disorders, neurovascular disorders Abbreviations: DPN, diabetic polyneuropathy; TLE, temporal SLE, systemic lupus erythematosus; SMA, Spinal muscular atrophy; lobe epilepsy; PWS, prader-willi syndrome; PD, parkinson’s CMT, charcot Marie Tooth disease; DHS, dropped head syndrome; disease; DLB, dementia with Lewy bodies; AVH, auditory verbal CIDP, Chronic inflammatory demyelinating polyneuropathy; LEMS, hallucinations; NES, non-epileptic seizures; BHS, breath-holding lambert-Eaton myasthenia syndrome; FSHD, facioscapulohumeral spells; GTCS, generalized tonic clonic seizures; SUDEP, sudden dystrophy; INEM, isolated neck extensor myopathy; MND, motor unexpected death in epilepsy; EEG, electroencephalogram; SE, neuron disease; PBP, Progressive bulbar palsy; PLS, primary Status epilepticus; PME, progressive myoclonic epilepsy; PMA, lateral sclerosis; OD, oropharyngeal dysphaiga; LNS, lesch-Nyhan progressive myoclonic ataxia; CNS, central nervous system; RLS, syndrome; REM, rapid eye movement; OGC, occulogyric crisis; restless legs syndrome; TS, tourette’s syndrome; SCI, spinal cord NMS, Neuroleptic malignant syndrome; SC, sydenham’s chorea; injury; LMN, lower motor neuron; UMN, upper motor neuron; FOSMN, Facial onset sensory and motor neuronopathy; TIA, FNP, Facial nerve palsy; MS, Multiple sclerosis; GBS, guallian- transient ischemic attack; FND, functional neurological disorder; Barre syndrome; MG, myasthenia gravis; CVA, cerebrovascular RCVS, reversible cerebral vasoconstrictive syndrome accident; NMO, neuromyelitis optica; PRS, parry romberg syndrome; BAD, brachial amyotrophic diplegia; LAD, leg amyotrophic Introduction diplegia; NNMD, neurological and neuromuscular disorders; NMD, Ayurveda is a traditional Indian system of medicine which has neuromuscular disease; DMD, duchenne muscular dystrophy; DM 1, great antiquity dating back to about 5000 years BC. It has stood myotonic dystrophy type 1; ALS, amyotrophic lateral sclerosis; HD, the test of time for four millennia or more.1 Charaka samhita is the huntington’s disease; SD, seborrheic dermatitis; PSP, Progressive most authoritative and comprehensive compendium of Ayurvedic supranuclear palsy; MSA, multiple system atrophy; CBD, corticbasal knowledge. This treatise is considered as the oldest available literature degeneration; AIDS, acquired immunodeficiency syndrome; EP, of Ayurveda.2 Charaka samhita has 8 sections (sthana) which contain exploratory procedures; ABS, anton Babinski syndrome; AIWS, a total number of 120 chapters. It is estimated to be redacted almost Alice in wonderland syndrome; VPD, visual perceptual distortions; contemporaneously with Aristotle and it is the most popular and RHS, ramsay Hunt syndrome; PTSD, post traumatic stress disorder; referral text book of medicine for Ayurvedic academicians, clinicians HS, horner syndrome; CPEO, chronic progressive external and researchers all over the world.3 ‘Indriya sthana’ is one among the ophthalmoplegia; MFS, miller fisher syndrome; SCD, spino cerebellar 8 sections of Charaka samhita. degernation; AD, alzheimer’s disease or alzheimer’s dementia; ADHD, attention-deficit/hyperactivity disorder; PRES, Posterior ‘Indriya sthana’ of ‘Charaka samhita’ comprises of 12 chapters reversible encephalopathy syndrome; SOL, space occupying lesion; which deals with prognostication of life expectancy based on ‘Arishta SSPE, subacute sclerosing panencephalitis; RA, rheumatoid arthritis; lakshanas’ (fatal signs and symptoms which indicates imminent death). Arishta lakshanas are the fatal signs which definitely occurs in Submit Manuscript | http://medcraveonline.com Int J Complement Alt Med. 2020;13(3):107‒119. 107 ©2020 Mamidi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and build upon your work non-commercially. Copyright: Neurological conditions in Charaka Indriya Sthana - An explorative study ©2020 Mamidi et al. 108 a diseased person (sometimes even in healthy persons also) just before mentioned throughout ‘Charaka Indriya sthana’ in a scattered way.5 –16 death. Physician should be alert to identify the arishta lakshanas The present study attempts to screen various references pertaining to whenever they manifest, incorporate them in calculating remaining neurological conditions of ‘Charaka Indriya sthana’ and explore their life expectancy and also in clinical decision making.4 ‘Charaka Indriya rationality, clinical significance and prognostic importance in present sthana’ holds ample of references of various clinical conditions which era. The neurological conditions (except ‘Dementia’, ‘Delirium’ and are having poor prognosis, fatal and generally seen in patients who neuropsychiatric conditions) of ‘Charaka Indriya sthana’ have been are at the end-of-life stages. Various neurological conditions are explored in the following sections (Table 1). Table 1 Neurological conditions in Charaka indriya sthana References in Charaka indriya sthana Relevant neurological conditions Neuropathies ‘Swedanubandha sweda stambho vaa’ (Ch. I. 3 / 4) Hyperhidrosis; Anhidrosis; Dyshidrosis; ‘Kesha lomaani -- na chet vedayeyu’ (Ch. I. 3 / 6) Hypoestheisa; Hypoalgesia; Peripheral neuropathy; Diabetic polyneuropathy (DPN); Seizures & Movement disorders: ‘Asattama pashyati -- badhyate’ (Ch. I. 5 / 21) Epilepsy; Temporal lobe epilepsy (TLE); Advanced dementia; Status epilepticus (SE); Non-epileptic seizures (NES); Sudden unexpected death in ‘Hrasvam cha ya -- punarvasu’ (Ch. I. 7 / 25) epilepsy (SUDEP); Generalized tonic-clonic seizures (GTCS); Cortical myoclonus; Movement disorders; Cerebrovascular events; Hyperactive subtype of delirium; ‘Ghattayajjanuna -- na sa jeevati’ (Ch. I. 8 / 17) Cortical myoclonus; SE; Restless legs syndrome (RLS); Sensory aspects of movement disorders; Psychogenic ‘Muhurhasan -- na sa jeevati’ (Ch. I. 8 / 20) movement disorders; Versive seizures; Post-traumatic syringomyelia; Spinal cord injury (SCI) at the level of ‘Shiro vikshipate -- chyuta bandhana’ (Ch. I. 8 / 26) cervical spine; Cervical dystonia with focal hyperhidroiss; Paralysis / Plegia / Paresis: ‘Gulpha chyuta’ (Ch. I. 3 / 5) Foot drop due to central or peripheral causes; ‘Bhru chyuta’ (Ch. I. 3 / 5) Horner syndrome; Facial nerve palsy (FNP); Bell’s palsy; ‘Vyavrutta murdha -- preta stathaiva sa’ (Ch. I. 7 / 29) Idiopathic facial nerve palsy; Multiple sclerosis (MS); Cerebrovascular accidents (CVA); Neuromyelitis optica ‘Bhruvau yasya chyutau -- jeevitam’ (Ch. I. 10 / 6) (NMO); Aneurysms; ‘Varna bhedhena -- vyakhyaataa’ (Ch. I. 1 / 10) Hemiplegia; Paraplegia; FNP; Bell’s palsy Neurological and neuromuscular disorders (NNMD); Amyotrophic lateral sclerosis ‘Stabdhaa nishchetana -- visarpini’ (Ch. I. 8 / 14) (ALS); Progressive bulbar palsy (PBP); ‘Bhedham swaro’ (Ch. I. 12 / 51) Dysphonia due to recurrent laryngeal nerve involvement; Vocal cord paralysis; Parkinsonism: ‘Pakshmaani jataabadhaani’ (Ch. I. 3 / 6) Seborrheic dermatitis (SD) in Parkinson’s disease (PD); ‘Shareera kampa -- na jeevati’ (Ch. I. 11 / 10) PD; Ataxia; Atypical parkinsonian syndromes; ‘Gomaya choornaabham -- tasya jeevitam’ (Ch. I. 12 / 3) PD; Immunocompromised state associated with PD and SD; ‘Nikashanniva -- vasati maanava’ (Ch. I. 12 / 4) Parkinsonian