bells palsy is ayurvedic text which gives brief information in ppt manner

1. ARDITA VATA
By Shabana Parveen

2. HISTORICAL REVIEW OF ARDITA
VEDIC KALA
There is no specific reference found regarding
Ardit in any of the vedas.
SAMHITA KALA (200. B.C.- 400 A.D.)
Samhita granthas consists of detailed decription
regarding Ardit,
CHARAK SAMHITA (2nd Century B.C.)
Ardit is considered among eighty Nanatmaj
Vatavikaras (Ch. Su. 20/11). It is also described as
the disease of Madhyam Roga Marga. i.e. Marm-
Asthi-Sandhi Marga

3.  involvement of unitateral limbs as well as face.
(Ch. Chi. 28/36-40)
 Chakrapanidatta (11th Century) clarifies the
differentation between Ardit and
 Pakshavadha by explaning Ardita as “Vegitaya
Na Sarvakala” and and Ardhangatata as
“Sarvakalo Vyapya”
SUSHRUT SAMHITA : (2 A.D.)
 The first chapter of Nidanasthan, deals with
Nidana, Rupa and Asadhyata of Ardit. Ardit is
described indicating involvement of unilateral
face only. Sushruta has given specific line of
treatment for Ardit

4. MADHAV NIDANA (7th Cen.)
It is said that “Nidane madhavashreshtha” in
praise of Madhavanidana. Ardit has been
described with causative factors, pathogenesis,
signs and symptoms as well as prognosis,in the
chapter 22nd Vatavyadhinidanam.
SHARANGDHARA SAMHITA (13th Cen.)
Ardita has been enumerated among eighty-vata-nanatmaj
disorders.
BHAVAPRAKASH (16th Cen.)
Bhavaprakash has described types of Ardita
separately with specific line of treatment for it.

5. ETYMOLOGY
 The word ‘Arda’ means to afflict, torment, strike,
hurt, kill etc.
 ‘Ardana’ means distressing, afflicting, pain,
trouble, anxiety, exitement, agitation, killing,
hurting, giving pain, etc.
 word ‘Ardit’ is suffered or affected, likewise,
suffering from pain, shula, hikka, swasa etc.
 Charakasamhita describe it with involvement of
unilateral limb & face.
 while Sushruta samhita made a specification for
it,only related to face.

6. NIDANA
“Garbhene suthikabala vruddikshene vyasruk kshaye
Uchayvyar haratho asyartham kadathah katinani cha ”
The pregnent women, women
after delivery, children, old persons,the
debilitated anaemic persons, those who speak
loudly, eat hard foods, laughing, yawning,weight
lifting, improper posture in bed.

8. SAMPRAPTHI GHATAKAS
Dosha ꞉ Vata
Dushya ꞉ Rasa,raktha,mamsa
Srothas ꞉ Rasa,raktha,mamsa
Srothodusti ꞉ Atipravritti
Udbhava sthana ꞉ Urdhwa jathru
Vyaktha sthana ꞉ Urdhwa jathru
Roga marga ꞉ Madhyama

9. PURVA RUPA
“Yasyagrajo romaharshe vepayurnetramavilam,
Vayururdhva tvachi svapasthadho manyahanugraha”
Roma harsha (horripilations)
Vepathu (tremors)
Netra avilam (turbidity of the eyes)
Vayu urdhvam (upward movement of eyes)
Manya graham (catching pain in shoulder)
Hanu graha (catching pain in lower jaw)

10. RUPA
“Vakribhavathi vakrardham griva chapyaparvarthathe
Sirschalathi vaksango netradinam cha vaikrutham”
Mukha vakrata (deviationof one side of mouth)
Greeva chapya (Neck deviation)
Sira chalati (tremors of the head)
Vak sanga (speech impairement)
Vaikrta nertradi (inability of closure of
eyes,eyes brown deviation etc).

11. According to charaka
Difficulty in eating
Netra stabadam
Kshavadhu nigruhyata
Danta chala
Swara bedha
According to Susrutha
Ardita in emaciated persons, who don’t wink their
eyes,whose speech is slurred.
Whom it is persisting for more than 3years is
incurable.

12. PATHYA
Oushadha:
Sad bindhu taila
Bhunaga taila
Sigru bija taila
Visa tinduka vati
Ahara:
Milk boiled with Pancamula,
Juice of sour fruits
Soups of meat & corn.
Fatty & salty foods.

13. VIHARA
 Pouring liquids on the body containing
leaves of Kumkuma, Agaru,Kusta, Ela,
Tagara body covered with Silk,wool,
cotton.
 Residing in places with mild breeze and
sunlight.
 Use of soft bed,
 Maintaining celibacy.

14. APATHYA
AHARA
Unwholesome diets of vata vyadi:-
Gram,Peas,Nirvaara,Kuruvinda and varieties of
Paddy and Flour obtained from kodruva and
Syama grains.
Others like Milk,Barely, Leafy vegetables,Dried
meat,Honey,Citrus,Sour & bitter eatables
Water from Ponds,Rivers & Contaminated
waters.

15. VIHARA
Harmful activities for the patient of vata vadhi
disease include:-
 Worrying
 Remaining waked
upto late night
 Suppression of
natural urges
 Vomiting
 Langana
 Sexual intercourse
 Blood letting,
 Lying idle for hours,
 Walking a lot,
 Bathing,
 Rubbing the teeth

16. CHIKITSA OF ARDITA
 ‘Nidana-parivarjana’ by Sushruta samhita
(Su. Utt. 1/25)
 While Vagbhatta provokes that
disintegretion of Samprapti is Chikista.
 The general treatment principle of
Vatavyadhi is mentioned before, among
which ‘Snehana’ is main tool.

17.  Specific treatment of
Ardita stated in
Sushruta is –
 Mashtishkya,
 Shirobasti
 Nasya
 Dhum
 Upanah
 Sneha
 Nadisweda, etc.
A formula of kshirataila
is also given and
indicated for
Pana,
Abhanga, etc.
Akshitarpanam by
kshirsarpi is also
suggested
(Su. Chi. 5/22).(28)

18.  As per Charaka:
Tailas:-For Nasya
 Anu taila
 Shad bindu taila
 Ksheera bala tailam
 Bhunaga tailam
 Maharaja prasarini
tailam
 Murdhina taila over
head
 Abhyanga
 Seka
 Pichu
 Siro-vasthi
are also mentioned.

19. Similarly, Navana & Moordhnitaila are
indicated by Ashtang Sangraha & Astanga
Hridaya.
Specific indication of Vamana and
Siravyadha are also found (A.H.Chi.21/43,
A.S.Chi. 23/10).

20. Bell’s Palsy
By Shabana Parveen

22. Oh my God I’m having a Stroke
 You wake up one morning, and your face
feels stiff and odd. When you look in a
mirror, half your face appears to droop. You
can only manage half a smile, your eye is
dripping tears and doesn't want to close.
What in the world is going on?

23. No silly it’s Bell’s Palsy
 If your muscle weakness or paralysis
affects only your face, a more likely cause
is Bell's palsy.
 Defined as temporary facial paralysis
Trauma or damage to the 2 facial nerves

24. Who is this Bell guy?
 Charles Bell
Well known for his studies on the nervous
system and the brain
In the 19th century discovered that lesions of
the 7th cranial nerve causes facial paralysis

25. 
 HOW COMMON IS BELL'S PALSY?
Bells palsy is not as uncommon as is
generally believed. Worldwide statistics set
the frequency at just over 0.02% of the
population (with geographical variations).
In human terms this is 1 of every 5000 people
over the course of a lifetime.
 IS BELL'S PALSY ALWAYS ON THE SAME
SIDE?
The percentage of left or right side cases is
approximately equal, and remains equal for
recurrences.

26. ANATOMY OF FACIAL NERVE
 The 7th cranial nerve is paired
with the
structure that travels through a
narrow,
bony canal (called the Fallopian
canal) in the skull
 beneath the ear
 to the muscles on each side of
the face.
 The nerve is mostly encased in
this bony shell.

28. FACIAL NERVE PHYSIOLOGY
Each nerve controls:
 Eye blinking and closing
 Facial expressions
 Smiling and frowning
 Tear glands
 Saliva glands
 Muscle of small bone in middle of ear called the
stapes
 Taste sensations

29. Etiology
 Mostly unknown
 May be caused by a viral infection
Viral meningitis
Herpes simplex
 Influenza
 Headaches
 Chronic ear infections
 High blood pressure
 Diabetes
 Sarcoidosis
 Tumors
 trauma

30. Idiopathic facial palsy (Bell's Palsy)
 Most common cause of facial paralysis (>50%
of case)
 Most age 25-30 yrs.
 Male : Female = 1 : 1
 Left side : Right side = 1 : 1
 Unilateral > bilateral
 Increase risk in
pregnancy 3.3 times
DM 4.5 times
 Recurrent rate 10%

31. SIGNS & SYMPTOMS
 Varies from person to person
 Comes on suddenly
 Mild to total paralysis
 Weakness, twitching on one of
both sides of the face
 Facial and eyelid droop
 Drooling
 Dryness of eye or mouth
 Impairment of taste
 Excessive tearing of eye

32. Other S/S
 Pain or discomfort in jaw and behind the ear
 Ringing in one or both ears
 Loss of taste
 Headache
 Hypersensitivity to sound
 Impaired speech
 Dizziness
 Difficulty eating and drinking

33. Sunderland classification of nerve
injury
1° damage = Compression
2° damage = Interruption of axoplasm
3° damage = Disruption of myelin
4° damage = Disruption of perineurium,
myelin and axon
5° damage = Transection of nerve

34. Physical examination
 ENT exam
 Nervous system
 Location
 Severity

35. INVESTIGATIONS
There are no specific lab tests to confirm diagnosis
 Will exam for upper and lower facial nerve
weakness
 Electromyography
 MRI and CT

36. Differential Diagnosis
 Ramsay Hunt Syndrome Type – 2
 Lyme Diseases

37. Treatment
 Corticosteroids :
prednisolone 1 mg/kg/day 7-10 days
 Corticosteroids combine with antiviral drug
is better
 Acyclovir 400 mg 5 times/day
 Famciclovir and valacyclovir 500 mg bid

38. Surgical treatment
 Surgery is treatment of choice for :-
 Facial nerve decompression
 Indications for facial nerve exploration
 incomplete paralysis
 iatrogenic paralysis
Appropriate time for surgery is 2-3 weeks
after paralysis
 Contraindications : any case have no
poor prognostic factors

39. Treatment Cont.
 Hard to close eye
Use and eye patch
Eye drops
Tape eye shut when sleeping

40. Complications
 Complications of facial nerve
decompression
Dripping tears
conductive or sensorineural hearing loss
vestibular function loss
persistent CSF leaks
meningitis
injury to the anterior inferior cerebellar
artery (AICA) or its branches

41. When does it go away?
 Outcome is good!!!
 Total recovery depends on amount of damage to nerve
 Improvement is gradual
 Usually start to get better after 2 weeks of onset and
most recover completely within 3 to 6 months.
 In a few cases, the symptoms may never completely
disappear.
 In rare cases, the disorder may recur, either on the
same or the opposite side of the face.