Tropical Ataxic Neuropathy: An Integrative Ayurvedic Approach in the Management of Dushivisha Janya Vatavyadhi

Abstract

Tropical Ataxic Neuropathy (TAN) is a rare, chronic neurodegenerative disorder seen in tropical populations, associated with prolonged consumption of improperly processed cassava containing cyanogenic glycosides, compounded by micronutrient deficiency, particularly of thiamine. Materials and Methods A 40-year-old male presented with a three-year history of progressive sensory ataxia, bilateral sensorineural hearing loss, tinnitus, visual disturbance, and slurred speech, with chronic dietary cassava intake. Examination revealed wide-based ataxic gait, and positive Romberg's sign; audiometry confirmed bilateral sensorineural hearing loss. The condition was diagnosed as Dushivisha Janya Vatavyadhi (Anukta Vatavyadhi), with vitiation of Prana, Udana, and Vyana Vata and progressive Dhatukshaya. Chronic cassava ingestion was considered Dushivisha, precipitating Agnimandya, Ama formation, and Srotodushti. Management included Koshtashodhana, Sarvanga Abhyanga, Nasya with Lashunaksheerapaka, Shashtika Shali Pinda Sweda, and Mustadi Rajayapana Basti, with supportive Shamana Aushadhis. Results: notable improvement in speech clarity and vision, with modest gain in tinnitus and gait. Markedly reduced lower-limb tingling and further improved gait, easing tandem walking, though Romberg's sign persisted. Discussion: This case illustrates the interplay of chronic neurotoxicity, gut–brain axis dysfunction, and micronutrient deficiency in TAN pathogenesis, and demonstrates the potential of Ayurvedic Vata-hara approach in a chronic neurodegenerative disorder.