Role of panchakarma in Trigeminal Neuralgia.

1. ROLE OF PANCHAKARMA
IN TRIGEMINAL
NEURALGIA

2. INTRODUCTION
Is one among the twelve pairs of cranial nerves
Has three major branches
-Ophthalmic
-Maxillary
-Mandibular
Is a chronic pain disorder
Occurs in 1 in 8000
Over 50 years of age
Lacinating pain in the 2nd and 3rd divisions of the
trigeminal nerve territory.

3. CONTD…
Usually presents as facial sensory loss / weakness of jaw
muscles.
Frequent excruciating pain in lips, gums, cheek or chin
Duration
Seconds – minutes
Simulated at trigger points
Types – Typical
Atypical

4. PATHOPHYSIOLOGY
Aberrant loop of the cerebellar arteries
Compres the trigeminal nerve as it enters the brain stem.
When occurs in multiple sclerosis, there is a plaque of
demyelination in the trigeminal root entry zone.

5. CLINICAL FEATURES
 Severe pain (repetitive)
 Precipitated by touch,
 Blowing of cold wind over the face
 By eating
 Similar symptoms occurs in multiple sclerosis
 Rarely in other brain stem lesions

6. ANATOMY OF THE NERVES INVOLVED
IN TRIGEMINAL NEURALGIA
 Ophthalmic branch leaves ganglion and passes forward to the
superior orbital fissure via the wall of cavernous sinus, supplies
sensation to the upper eye lid, forehead and scalp eye.
 Maxillary branch passes the ganglion via the cavernous sinus to
leave the skull by the foramen rotundum.
contains sensory fibres from the mucous membranes of the mouth,
roof of pharynx, gums, teeth, palate of the upper jaw and the maxillary
sphenoid and ethmoid sinuses.
 The mandibular branch exits the skull via foramen ovale and
supplies to the mouth.

7. EXAMINATION
Sequence:
Sensory – neurological pin test,
nasal tickle test
Motor- wasting of muscles of mastication
look for deviation
2 reflexes – corneal reflex
jaw jerk

8.  TRIGEMINAL
NURALGIA IN AYURVEDA

9. VATAJA SIRASOOLAM
 तत्र मारुतकोपत:।
निस्तुद्येते भृशं शङ
् खौ घाटा सम्भिद्यते तथा॥
भ्रुवोममध्यं ललाटं च पततीवानतवेदिम्॥
बाध्येते स्वित: श्रोत्रे निष्क
ृ ष्येत इवानिणी॥
घूणमतीव नशर:सवं सम्भिभ्य इव मुच्यते॥
स्फ
ु रत्यनत नसराजालं किराहिुसङ् रह:।
प्रकाशासहता घ्राणस्रावोऽकस्माद्यथाशमौ॥
मादमवं मदमिस्नेहस्वेद बििैश्च जायते।
नशरस्तापोऽयम् (अ.हृ.ऊ.२३/३-६)

10. ANANTAVATAM
दोषस्तु दुष्टास्त्रय एव मन्ां संपीड्य घटासु रुजां सुतीव्राम्॥
क
ु वमम्भि सानिभ्रूनव शङ
् खदेशे म्भथथनतं करोत्याशु नवशेषतस्तु॥
गन्डस्य पार्श्वे तु करोनत कम्पं हिुरहं लोचजांश्च रोगाि्॥
अििवातं तमुदाहरम्भि दोषत्रयोत्थं नशरसो नवकारम्॥
(सु.उ.२५/१३-१४)

11. ARDHAVABHEDA
यस्योत्तमाङन्गार्ममतीव जिो:संभेदतोदभ्रमशूलजुष्टम्॥
पिाद्दशाहादथवाऽप्यकस्मात्त्स्स्यार्म भेदं नत्रतयावस्वस्येत्॥
(सु.उ.२५/१५)
नशरानिस्पन्दताऽऽलस्यं रुग्मन्दाऽह्न्नर्का निनश।
(अ.ह.उ.२३/१०)

12. SANKHAKA
 (SU.U.25/16)
 Vata gets aggravated associated with pitta, kapha and rakta and
produces tivra ruja in the shankha pradesha.
 (A.H.U23/16-17)
 Aggravated Vata with the predominance of other doshas
produces tivra ruja,daha

13. CHIKITSA
Vataja sirasoola
Shira is annointed & ghrita is consumed at night
followed with ushnambu.
Pinda seda or upanaha with mamsa and dhanya are
beneficial
Sechanam with ksheera boiled in dasamula or
othervataghna dravyas.
Snigdha Nasyam and dhumapanam (A.H.U.24/1-3)
Drugs of varanadi gana is boiled in 1 part milk with half
quantity of water and redued to ksheeravashesham.the
butter is taken out by churning & is cooked with
madhura rasa dravyas for nasyam.(A.H.u.24/4-5)

14. Contd..
Snehika dhuma (Su.U.26/10)
Trivrita taila/ bala taila is used as
paana,abhyanga,nasya,basti ,sechanam

15. ARDHAVABHEDA
Sirisha beeja,apamarga mula added with bida – nasyam
(A.H.U.24/9)
Avapida nasya- from sirisa,mulaka,karpura or from vacha
and Magadhika or from madhuka mixed with honey or
from manasila along with honey and chandana
(su.u.26/35)

16. ANANTHAVATAM
Siravyadham (su.u.26/36) (A.H.u.24/10)
Nasyam is done.

17. Karnapuranam – for hanu,manya,sira,karna
sulagnam with taila eg: ksheerabala, tila
taila,etc

18. THANK YOU