Treating Ataxia the Ayurvedic way

Allopathy or the modern system of medicine labels it calls it  degenerative and often fatal disorder. It says there is no known effective treatment  for this condition. However, Ayurveda, which is perhaps the oldest system of medicine has a cure and today many doctors and hospitals are prescribing Ayurvedic cure for Spinocerebellar ataxia or SCA) as it is called.

SCA is called a progressive, degenerative  and genetic disorder which is neurodegenerative in nature. Allopathy says there is no known cure and that it can affect anybody of any age as it is caused by a gene.

Surprisingly, people are just not aware that they carry the ataxia gene until they have children who begin to show signs of having it. More than 60 different types of SCA have been identified.

SCA disorder leads to lack of coordinated walk or gait, poor coordination of the limbs and even eye movement. The disorder makes patients with SCA move their hands rather frequently and intentionally. We can also see clumsy motion of a body as there is lack of proper muscle movement.

Ataxia is thus a symptom, not a disease. It is a specific term coined for poor coordination of movement and most people suffering from ataxia walk in a  uncoordinated and unsteady manner.

Ataxia is known to affect coordination of fingers, hands, arms, speech

(dysarthria) and eye movements (nystagmus).  

Axtaxia generally results from damage to or shrinkage of the cerebellum and it is this part of the brain that controls coordination of movement. The disorder can be acquired or inherited as it is hereditary.

Thus we see that Spinocerebellar Ataxia is an illness that occurs when parts of the nervous system that control movement are either damaged or cease to function.

Some of the symptoms include lack of sleep or uncoordinated sleeping,  tremors, stiffness, depression and even spasticity. Almost all of these and many other symptoms can be easily treated by medication.

Therapeutic measures combined with regular and intensive rehabilitation regimen can help such a patient to carry out daily chores themselves such as brushing the teeth or making and drinking water and coffee.

Ayurvedic medicines like Bruhat-Vat-Chintamani, Ekang-Veer-Ras, Tapyadi-Loh, Kaishor-Guggulu, Vat-Gajankush-Ras and Maha-Vat-Vidhvans-Ras are generally used for gait instability, tremors and even loss of movement.

A variety of herbal medicines like Ashwagandha (Withania somnifera), Bala (Sida cordifolia), Haridra (Curcuma longa), Naagbala (Grewia hirsuta), Shatavari (Asparagus racemosus), Yashtimadhuk (Glycyrrhiza glabra), and Mandukparni (Centella asiatica) and these are known to improve the blood supply to brain cells and help in regeneration of the cells.
Besides, medicines such as Brahmi (Bacopa monnieri), Shankhpushpi (Convolvulus pluricaulis) and Vacha (Acorus calamus) are used to improve memory and intellect.  Jatamansi (Nardostachys jatamansi), Jayphal (Myristica fragrans), Khurasani ova (Hyoscyamus niger) and Tagar (Valeriana wallichii) are prescribed to treat depression and anxiety. To improve neuro-muscular coordination, Ayurveda uses Rasna (Pluchea lanceolata), Agnitundi-Vati, Maha-Rasnadi-Guggulu, ishtinduk-Vati, Bhallatakasav, Trayodashang-Guggulu, Nirgundi (Vitex negundo), Kuchla (Strychnos nuxvomica) and Bhallatak (Semicarpus anacardium).

Panchakarma treatment is prescribed for regaining body strength. Regular massage and medication helps alleviate many of the symptoms.
Ayurveda and the Chinese system of medicine has a cure for this disorder. The Chinese system involves replanting stem cells and this research has been successfully carried out in St. Micheal’s Hospital, Shangai, China.

In India, Ayurveda addresses the core of SCA. It tries to alleviate the many symptoms that come with the disorder. It helps a SCA patient undertake and complete his daily chores.

Ayurveda can treat both hereditary and acquired ataxia. However, a majority of the ataxias are hereditary and they are classified by chromosomal location and pattern of inheritance.The more common inherited ataxias are Friedreich’s ataxia and Machado-Joseph.

Ataxia can also be acquired from vitamin deficiency, tumors, stroke, multiple sclerosis, alcoholism, peripheral neuropathy and metabolic disorders.

Allopathy says there is no cure for the hereditary ataxias. However, ataxia caused by a metabolic disorder or vitamin deficiency can be treated with medications and controlled diet. Regular physical therapy can strengthen muscles.

Ayurveda terms ataxias as Pandu roga. It says the reason for the disorder is  due to deficiency in liver function which depletes the Dhatu in the blood which in turn cause all these symptoms. Ayurvedic treatment starts with avoiding  fried food, artificial food, green/red chillies, tomatoe, lemon, tamarind, potato and curd.

The treatment options for improving the balance in degenerative cerebellar ataxias are very few. Ayurvedic texts have described diverse treatment regimens for this disease.

Ayurvedic treatment starts with treatment of Shirobasti (therapeutic retention of medicament over the scalp) in male patients and Shirodhara (pouring of a steady stream of medicament on the forehead) in female patients with Dhanvantaram taila (medicated oil).

This is followed by by Abhyanga  or methodical massage with Dhanvantaram taila and Bhashpa sweda, which is also known as steam bath.

Apart from these two methods, Ayurveda also prescribes Abhyantara aushadha or oral medicine of Maharasnadi kashayam, Dhanvantaram capsules and Ashwagandha.

Studies have shown that this treatment did not have any side effect and there was improvement in walking and other motor movement.

In Japan, doctors have reported improvement in a case of  familial spinocerebellar ataxia 6 with typical symptoms when the patient was treated with a mixture of 18 medicinal herbs (modified Zhengan Xifeng Tang). This treatment was based on the guidelines of traditional Chinese medicine. All  the symptoms showed improvement.

A word of caution and warning though. No treatment should be undertaken on its own. Consult your family doctor first and then turn to an expert Ayurvedic expert. Even messaging correctly should be learnt from an expert.  

Fishing for blood clots

Nets are generally used by fishermen to catch fishes. But can you imagine a net to retrieve blood clots from a human body.  What is more, these are clots or thrombi that have formed due to stroke and they have stopped the supply of oxygen and blood to the brain, causing paralysis.

Such nets are now being used regularly in the United States to get to the blood clots and remove them from the brain of patients who had suffered a stroke or have had a series of strokes.

Generally, upwards of four strokes occur in a human being when blood clots block a blood vessel from carrying blood to the brain. When the clot stops the flow of blood, the brain is starved of oxygen and glucose and the cells die by millions, damaging the tissues (infarcts) leading to paralysis and in some cases even death.

Till now, the clots were removed or dissolved with the help of drugs. The drug, rt-PA, is almost fully effective if administered to victims within three hours of a stroke felling them. Unfortunately, it fails to dissolve large blood clots.

Doctors also use anticoagulants, which are popularly known as blood thinners, to treat clots. These medications- heparin, low molecular weight heparin, and warfarin-slow the time it takes for blood to clot and also prevent growth of a clot. However, all of them have side effects.

Other techniques to remove a clot include MERCI Retrieval System, which can be used at any time. This is a minimally invasive catheter-based system to retrieve and remove clots in patients experiencing acute ischemic stroke. The catheter is inserted into the brain to remove the clot. Another option is the Penumbra System, but this can be used only within eight hours of a patient suffering a stroke. Here, suction is used to remove the clots and restore blood flow.

Now, a team of doctors and researchers in the US have successfully tested a new technique to remove clots. They have used small nets to get to the place where the clot has formed. The net is sent to the brain through an artery in the leg.

When the net reaches the clot, the tip expands into a net and pulls out the clot into itself.

The device has been named as Solitaire and it has so far yielded promising results in a recent medical trial at the University of California, Los Angeles. This devise is different from the MERCI and its success too is double of MERCI.

Researchers were stunned to find that when MERCI was used, 598 per cent of the patients reported improved mental and motor functioning within a three month period. This compared well with those treated with MERCI (33 per cent).

More importantly, only 17 per cent of those treated with Solitaire died following treatment compared to 38 per cent treated with the MERCI.

Another study involving 178 patients showed those  treated with Solitaire had almost double the chance of living independently after treatment.

Why this success rate?. One reason is that it has allowed doctors to  successfully open up arteries and save the brain. What makes this device all the more valuable to a patient suffering from stroke is that it has been proved to effectively reverse a stroke even while it is happening.

This is because the brain cells can survive if blood supply can be restored quickly. This is what Solitaire can do.

Moreover, it is always advisable to use clot retrieval devices than go in for clot dissolving drugs.

By the way, the Solitaire was approved by the US Food and Drug Administration (FDA) for use as a clot retriever in March 2012. This is actually called Covidien Solitaire FR Revascularization Device.

Dissolving blood clots

By the way, a John Hopkins study in the US has come up with a new technique to dissolve blood clots in brain and also lower the risk of brain damage after stroke.

The research is supported by the National Institute of Neurological Disease and Stroke

The technique which involves minimally invasive treatment   removes potentially lethal blood clots in the brain safely without cutting through easily damaged brain tissue or removing large pieces of skull.

More importantly, this technique was particularly successful in treating victims of intracerebral hemorrhage (ICH), which is considered to be the last  untreatable form of stroke.

ICH is caused by high blood pressure and in such cases the clot builds up pressure and leaches inflammatory chemicals. This leads to irreversible brain damage, causing death or extreme disability. Very few undergo the more invasive and risky craniotomy surgery, which involves removing a portion of the skull and making incisions through healthy brain tissue to reach and remove the clot. Roughly 50 percent of people who suffer an intracerebral hemorrhage die from it.

This new technique, if found positive, allows patients with stroke and paralysis to recover independent functioning of the organs that had been affected. The USP in this technique is that the brain remains safe and only a small hole the size of a coin is made in the skull to get to the damaged tissue which is then treated with rt-PA which is allowed to drip on the damaged cells.  

The brain museum

This should be one of the most unusual museums in India and it is certainly the first in the country.

Though India has museums on history, geography, wildlife, geology and other sciences, it rarely has a museum dedicated solely to medical science. Bangalore has been lucky in having this one in a kind museum and it is worth a visit.

This is the brain museum and it is located in the premises of the National Institute of Mental Health and Neurosciences (NIMHANS), at its sprawling campus just off Hosur Road.

The museum displays over 600 samples of human brain and these samples are increasing year by year.

The museum was the brainchild of Dr S K Shankar, professor and head of department of neuropathology. It was set up after a long and painstaking effort involving close to 30 years of brain donations.

NIMHAS had to seek permission of the next of kin of the dead during autopsy to take parts of their brain for research. The research team later stumbled upon some fascinating revelations that are otherwise generally not revealed through MRI scans.

These brain samples were initially  for teaching students of neuropathology. Later, the idea of educating the public and making them aware of the fascinating aspects of the brain began germinatng and the result was the museum.

The first thing when you step into the vast hall is the many samples displayed in bottles and jars of formalin. Just imagine, these were the very brains that controlled human beings just a few years ago and now they are objects of research and display.

The brains here come in all sizes and shapes. There are brains of people who died a natural death and those who suffered head or brain injury. There are brains which were diagnosed with certain diseases.

The brain that suffered an injury in an accident is perhaps one of the most evocative. The person had suffered a memory loss and this can be verified by the fact that the fibres going to the frontal cortex or frontal lobe was disconnected.

The frontal lobes helps us to recognize future consequences resulting from current actions, to choose between good and bad actions (or better and best), override and suppress socially unacceptable responses, and determine similarities and differences between things or events.

They also help in retaining longer term memories which are not task-based. These are often memories associated with emotions derived from input from the brain's limbic functions. It modifies those emotions to generally fit socially acceptable norms.

A few brains here show traces of intracerebral haemorrage (ICH) and by the way this is the second most common cause for a stroke. In these cases, the haemorrage occurs within the brain tissue rather than outside, making treatment and even recovery that much more difficult.

The risk factors for ICH include: hypertension, diabetes, menopause, current cigarette smoking and alcoholic drinks (≥2/day)

Brains which have faced the problem of cerebral venous thrombosis (blood clot) are also displayed. This is a peculiar phenomenon in north Karnataka where pregnant women are not given enough fluids after delivery. The blood of such women thickens. The clot occurs in the dural venous sinuses, which drain blood from the brain.

Another reason for such clots is consanguineous marriages which are very common in Karnataka, Andhra Pradesh and Haryana. They lead to developmental anomalies of the brain.

There are also samples of brains which were the study for Schizophrenia. Though there is no external manifestation or malfunction, the size of the brain has shrunk, indicating a severe abnormality.

The brains of  people suffering from Alzheimer’s disease too have shrunk. The nerves had withered and it is really a scary sight.

Interestingly, there are brains which have suffered injuries and infections when ears of people were being cleaned with a sharp object such as a pin, pen, pencil or any long object. The infection from the ear quickly spread to the brain and in some cases, the damage was irreversible.

What makes this brain museum interesting is that it has brains of animals too. There are on display the brain of a rat and a duck. It details facts about the brain like anatomy, physiology, psychology, psychiatry, neurology and even neurosurgery.

A single brain can be preserved for twenty years and thus we see more brains coming in to the museum every year.   

The museum is operated by the Department of Neuropathology.

It is open on Saturdays from 10 a.m., to 3 p.m. If you would like to donate your brain, sign a pledge as donor.

The complete address is NIMHANS, Hosur Road, SR Krishnappa Garden, Hombegowda Nagar, Bengalore, Karnataka 560029. You cal also call 080 26995035 for more details.