Ayurvedic Management of Neurogenic Ptosis Secondary to a Cavernous Sinus Lesion

Abstract

Cavernous sinus lesions may present with orbital pain, headache, visual disturbances, and progressive ptosis due to involvement of the cranial nerves traversing the sinus. This case highlights the role of Ayurvedic management as an adjunctive therapeutic approach. Methodology: A 55-year-old male with a history of hypertension and dyslipidemia presented with left orbital pain, left-sided headache, blurring of vision, double vision and progressive left upper eyelid ptosis of six months' duration. MRI brain demonstrated a heterogeneously enhancing left cavernous sinus-centered extra-axial lesion, suggestive of cystic degeneration of a schwannoma (probably involving the ophthalmic division of the trigeminal nerve) or a venolymphatic malformation. The patient underwent Ayurvedic treatment comprising Kashayadhara, Snehapana, Abhyanga with Ushma Sweda, Virechana, Ksheera Dhooma Nasya, Karnapoorana, Anjana, Shirovasti, Tarpana, and Putapaka, along with suitable internal Ayurvedic medications based on clinical assessment. Results: Following treatment, the patient experienced reduction in orbital pain and headache, along with gradual improvement in left upper eyelid ptosis and associated visual symptoms. The treatment was well tolerated, and no adverse events were observed during the treatment period. Conclusion: The multimodal Ayurvedic approach incorporating Shodhana and Brimhana therapies may help alleviate symptoms by addressing Vata imbalance and supporting neuromuscular function. Although structural lesions of the cavernous sinus require continued neurological and ophthalmological follow-up, this case suggests that Ayurvedic interventions may provide beneficial symptomatic support. Further controlled clinical studies are needed to evaluate their efficacy and establish evidence-based recommendations.