Article: MANAGEMENT OF ISOLATED SIXTH CRANIAL NERVE PALSY WITH VIDDHAKARMA AS AN ADJUVANT THERAPY: A CASE SERIES

Article Category: Case Reports

DOI: 10.7897/2277-4343.15229

Pages: 10-15

Author: Nutan R. Radaye *, Sandhyarani T. Patil, Chaitali K. Kulkarni

Abstract: Background: In Patients with Abducens nerve palsy, diplopia is the most common presenting symptom. Patient will have horizontal uncrossed diplopia which is greater at distance, which worsens in the direction of the palsied muscle and gets better in the contralateral gaze. Vasculopathic risk factors such as diabetes mellitus and hypertension are more common in elderly people due to microvascular ischemia. Treatment options with sixth cranial nerve palsy include alternate patching, prism therapy, strabismus surgery and botulism injections. Here, we present case series of two patients of Isolated Abducens nerve palsy, secondary to Diabetes Mellitus and Hypertension, who underwent Viddhakarma along with other Ayurvedic management. Data were collected prospectively with a follow-up of three months. Case Report: Two cases presented to the Out-patient department with pre-diagnosis of Sixth Cranial Nerve Palsy with signs and symptoms of binocular horizontal diplopia, inability to abduct left eye and mild esotropia secondary to hypertension and diabetes mellitus. In Ayurveda, symptom of Dwitiya Patalgat Doshdushti (Timira) by Acharya Vagbhata and Trutiya Patalgat Doshdushti (Timira) by Acharya Sushruta can be correlated with the diplopia. Snayugata vitiation of Vata Dosha leads to Ekangavata which causes constriction of Sira and Snayu. Thus, sixth cranial nerve palsy can be correlated with Ekangavata and Timira. Viddhakarma as an adjuvant therapy to the Ayurvedic treatment regimen, patients started showing improvement in the symptoms within one to one and a half months and symptoms resolved completely, thereby enhancing the quality of life of the patient. Conclusion: Neuro-ophthalmological cases related to cranial nerve palsies can be treated successfully with Ayurvedic management and Viddhakarma as an adjuvant therapy.

Keyword: Case series, Diplopia, Ekangavata, Isolated sixth nerve palsy, Timira, Viddhakarma.