COMPREHENSIVE AYURVEDIC MANAGEMENT OF HEREDITARY SPASTIC PARAPLEGIA WITH ATAXIA: A CASE REPORT

Abstract

Hereditary Spastic Paraplegia (HSP) is a rare, progressive inherited neurodegenerative disorder characterised by weakness and stiffness of the lower limbs. The complicated form may present with additional neurological manifestations, including cerebellar ataxia, tremors, seizures, and speech disturbances. The present case describes the clinical improvement observed following an individualised Ayurvedic treatment approach in a patient with HSP with ataxia. A 39-year-old male presented with gradually progressive weakness and stiffness of both lower limbs, difficulty in walking, imbalance, frequent falls, tremors, and unclear speech. He had a history of generalised tonic-clonic seizures and was receiving conventional treatment. Brain MRI at NIMHANS revealed mild diffuse cerebral and cerebellar atrophy, and he was diagnosed with HSP with ataxia. Based on Ayurvedic principles, the condition was managed as a Vata-dominant neurological disorder with Madhoodaka Pana, Sarvanga Udvartana with Kolakullathadi Churna, Agni Lepa, Matra Basti with Eranda Taila, Mukha Pratisarana with Vacha Churna and Madhu, Sarvanga Utsadana, Shastika Shali Pinda Sweda, Pratimarsha Nasya & Mustadi Rajayapana Basti followed by oral medications including Astavarga Kashayam, Yograja guggulu, Rasa Raja Rasa, and Ashwagandha Churna Outcome assessment using the Scale for the Assessment and Rating of Ataxia (SARA) showed post-treatment scores of 8. Improvement was observed in lower-limb stiffness, gait, balance, coordination, tremors, and activities of daily living. This case highlights the potential role of an integrated Ayurvedic and conventional approach in symptomatic management of HSP with ataxia and improvement of functional independence and quality of life.