Integrative ayurvedic approach in post-ischemic stroke rehabilitation with special reference to Pakshaghata: a case report

Abstract

Ischemic stroke, comprising approximately 85% of all strokes globally, is a major cerebrovascular disorder. In Ayurveda, a similar condition is identified as Pakshaghata, categorized under Vatavyadhi. It results from aggravated Vata dosha, which governs motor and sensory functions, invading the shareera dhamani and leading to hemiplegia, speech loss and pain. A 67-year-old male patient, known case of hypertension for 2 years with poor medication adherence, presented with weakness and pain over the right upper and lower limbs, difficulty in walking without support and restricted right upper limb movement since 1½ months. A cerebrovascular accident occurred on 21/04/24 during nocturnal hours, with subsequent right-sided hemiparesis, facial deviation and slurred speech. CT revealed a chronic lacunar infarct in the right corona radiata, while MRI indicated an acute infarct in the left posterior capsulo-ganglionic region. The patient was admitted to the Kayachikitsa IPD on 14/06/24 with spasticity, hemiplegic gait, muscle weakness, exaggerated reflexes and an extensor plantar response. Following 14 days of integrative Ayurvedic treatment, the patient regained the ability to walk without support and raise the right upper limb, reflecting enhanced motor function and quality of life. VAS score reduced from 9 to 0, Ama assessment score dropped from 6 to 0 and NIHSS score improved from 8 to 6 indicating reduced stroke severity. This case demonstrates the potential role of conservative Ayurvedic interventions in post-stroke rehabilitation.