A case study on Guillian barre Syndrome

Presenter –

Dr.Keerthana S

2^nd year PG scholar

Department of Panchakarma

Government Ayurveda Medical College, Mysuru

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Guided by –

Dr. Varsha kulkarni

Professor and Head

Department of Panchakarma

Government Ayurveda Medical College, Mysuru

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Contents

• INTRODUCTION
• NEED FOR SELECTING THE TOPIC
• MATERIALS AND METHODS
• OBSERVATION AND RESULT
• DISCUSSION
• CONCLUSION
• REFERENCES

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Introduction

• GBS is an acute, severe fulminant polyradiculoneuropathy that is autoimmune in nature and is characterized by acute onset of motor &/sensory weakness.
• In Ayurveda it can be understood in terms of Sarvanaga roga.

Need for selecting the topic

• GB syndrome occurs at a rate of between 1 and 4 cases per 100000 annually
• As this a rare autoimmune disease contemporary system of management includes plasma pheresis, immunoglobulin therapy etc
• In the present case study of GB Syndrome remarkable improvement was observed within 2 months of treatment
• And this paper is a sincere effort to share our experience and observations with you all.

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Materials and Methods

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Name – XYZ

Age – 63 yrs.

Sex – male

DOA- 21-11-22

DOD- 8-12-22

OP No- 379

IP No -1532

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Chief Complaints

• C/O sudden loss of strength in bilateral upper and lower limb
• Inability to get up from sitting / supine position
• Inability to stand/ walk

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15 days

History of Present illness

• A male patient aged 63 years who is not a k/c/o DM/ hypertension was otherwise normal 3 weeks back. He experienced weakness of lower limb while riding two wheeler and developed pain in b/l calf muscles. Following which he noticed complete loss of strength in b/l lower limb and upper limb associated with myalgia and heaviness all over the body, inability to get up from sitting and supine position, inability to stand/ walk. The disease was sudden onset and progressive in nature.Thus approached our hospital for betterment.

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General examination

• Built – Lean
• Nourishment – Moderately nourished
• Pallor - Absent
• Icterus – absent
• Clubbing – Absent
• Lymphedenopathy – Absent
• Oedema – Absent
• Cyanosis – Absent
• Tongue – coated
• Weight – 65.6kg
• Height -160cm

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Systemic examination

• Respiratory system –
• Cardiovascular system-
• GI System –
• CNS examination –

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NAD

Sensory system – intact

Lab investigations

Diagnosis

Sarvangaroga

• सर्वाङ्गं सर्वदेहजमिति सर्वाङ्गलक्षणम्,
• कुर्याच्चेष्टानिवृत्तिं
• रुजं
• गृहीत्वाशरीरस्य सिराः स्नायूर्विशोष्य च

• Sudden onset of Ascending paralysis.
• The weakness can be symmetrical with motor paralysis
• Areflexia

Guillian barre syndrome

�Treatment given

Treatment given -

• Agnichikitsa lepa

Teekshna

Ushna, sukshma guna

Ushna veerya

Kapha vatahara

Vedanasthapaka

Shotha hara

Internally-5gm

• AMAPACHANA
• AGNIDEEPANA
• SROTOSHODHANA

Mustaadi raja yapana basti

• Madhu – 30ml
• Saindhava lavana – 5gm
• Ashwagandha ghrita – 80ml
• Mustaadi kalka – 15gm
• Mustadi yapana Ksheera kashaya – 300ml
• Aja mamsarasa – 100ml

Anuvasana basti – Ashwagandha ghrita – 80ml

Oral medications

Before treatment

After treatment

Observations and Results

Before treatment

After treatment

Discussion

Amavisha

Tridosha prakopa in different dhatu

Rasa

Vata - angamarda

Kapha - gouravata

Rakta

Vata – teevra ruja

Pitta- Dushti of sira and kandara

Ruksha,sheeta guna of vata

teekshna ushna guna of pitta in Kandara

?myalgia

?Demyelination of peripheral nerves

?Areflexia

Nidana – agantuja?

? Immunological response

Medo dhatu (snayu)

V- Pangu

Asthi majja

Vyana V– teevra balakshaya in adhoshaka

teekshna ushna guna of pitta and ruksha guna of vata

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?Loss of strength in lower limb

Mamsa

KV - guruta ,toda

Guru manda guna of kapha

? Flaccidity of extremities

?Demyelination of peripheral nerves

?Ascending paralysis

SARVANGA ROGA

?GB Syndrome

• Hence, this case can be understood in two phases

Ama formation further leading to Tridoshaprakopa in Rasa rakta dhatus

Gatavatalakshana in Rakta, Mamsa ,Meda, Snayu , Asthi-Majja dhatu.

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The treatment was planned in two phases

• Amapachana and Agni deepana at Koshta, Rasa and Rakta dhatu level. Agnichikitsa lepa externally + internally
• Nimbamrutadierandataila pacify Vata and Pitta prakopa in Rasa and Rakta dhatus and also to provide Raktaprasadana and Apana vataanulomana as there was Adha kaya balakshaya.
• Nimbamrutadierandataila does Virechana which is the Chikitsa for Raktagatavata.

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Conclusion

• On attaining niraamavastha- Brimhanachikitsa in the form of Abhyanga + Shashtika shali pinda sweda , yapana basti was administered to treat the mamsa, asthi-Majjagatavata dosha
• It helped in increasing the power of the lower extremities and fastened the formation of myelin sheaths in the peripheral nerves of lower extremitiesv;
• Internally- Amapachana followed by Brimhana and rasayana was given.

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References

• Charaka Samhita Chikitsa Sthana Vatavyadhi chikitsa
• Charaka Samhita Siddhisthana Phalamatra siddhi adhyaaya
• Sushruta Samhita sutra stnana Vranalepana bandhana vidhi adhyaya
• Keraliya Chikitsa paddhati
• Hwang, D., Vasquez, I., Galvez, L., Do, H., Lopez de Santa Ana, A., Matta, S., Zhou, F., Chen, M., & Russo-Neustadt, A. (2017). Ashwagandha and Its Active Ingredient, Withanolide A, Increase Activation of the Phosphatidylinositol 3’ Kinase/Akt Cascade in Hippocampal Neurons. European Journal of Medicinal Plants, 20(2), 1–19. https://doi.org/10.9734/EJMP/2017/35355
• Other Journals and Review articles related to GB syndrome, Basti etc

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Thank you