Ayurvedic Neuro-Rehabilitation After Surgical Resection of Intramedullary Ependymoma

Abstract

Ependymomas are rare neuroectodermal neoplasms of the central nervous system. Intramedullary ependymomas arise from the ependymal cells lining the central canal of the spinal cord and account for approximately 50–60% of intramedullary spinal cord tumors in adults, with a peak incidence in their fourth decade of life and a slight male predominance. These tumors result in progressive neurological deficits due to compression and infiltration of spinal cord tracts, with clinical manifestations varying according to the level and extent of involvement. Surgical resection remains the treatment of choice, as intramedullary ependymomas are usually well circumscribed and amenable to gross total excision. However, post-operative neurological deficits and functional impairment may persist, necessitating structured and prolonged neuro rehabilitation. From an Ayurvedic perspective, the clinical features and post-operative neurological deficits can be correlated with conditions such as Dhatu ksayajanya Vatavyadhi and Upadhatu Pradosaja Vyadhi and Sarvangavata, depending on the stage of disease and symptomatology. Therapeutic principles including Ksataja sopha cikitsa, Dhatu posana, Vatavyadhi cikitsa, and Rasayana chikitsa, along with appropriate rehabilitative measures, may be adopted to support neurological recovery and functional improvement.