MANAGEMENT OF PAKSHAGHATA WITH MUSTADI RAJA YAPANA BASTI: A CASE REPORT

Abstract

Background: Pakshaghata is one of the major Vata Vyadhi described in Ayurveda and is clinically comparable to hemiplegia following ischemic stroke. Although advances in acute stroke management have improved survival, many patients continue to experience persistent neurological deficits requiring long-term rehabilitation. Ayurveda advocates a multimodal treatment approach involving Panchakarma procedures, internal medications, and rehabilitative therapies to enhance functional recovery. Case Presentation: A 63-year-old male presented with right-sided hemiplegia associated with slurred speech, deviation of the angle of the mouth towards the left side, and difficulty in walking for two years following an ischemic stroke. He had initially received conservative treatment at a modern medicine hospital but remained functionally dependent with persistent neurological deficits. He was subsequently admitted to an Ayurvedic hospital for further management and rehabilitation. Intervention: The patient underwent an integrative rehabilitation protocol comprising Nasya, Mukhabhyanga, Dhoomapana, Shirodhara, Vestana, Udwartana, Sarvanga Abhyanga with Swedana, and Mustadi Raja Yapana Basti, along with appropriate internal Ayurvedic medications and physiotherapy. Outcome: Improvement was observed in motor function, speech, gait, activities of daily living, and overall functional independence. Clinical outcomes were assessed using the National Institutes of Health Stroke Scale (NIHSS) and the Barthel Index, which demonstrated improvement following the intervention. Conclusion: This case highlights the potential role of an integrative Ayurvedic rehabilitation protocol incorporating Panchakarma procedures and physiotherapy in improving functional outcomes in a patient with chronic Pakshaghata following ischemic stroke. Further well-designed controlled clinical studies are warranted to establish its efficacy and safety.