Ayurvedic Management of Pakshaghata (Post Stroke Hemiplegia)

Abstract

Pakshaghata is one among the eighty Nanatmaja Vata Vyadhis afflicting half of the body due to vitiation of Vata Dosha. In contemporary medicine, it closely resembles hemiplegia following ischemic stroke, which remains a major cause of long-term disability worldwide. This case report presents a 47-year-old male with left-sided hemiplegia secondary to right middle cerebral artery occlusion. Clinical findings included spasticity, reduced muscle power (2/5 in left upper limb and 3/5 in left lower limb), slurred speech, impaired gait, and severe dependence in activities of daily living (Barthel Index – 35; Modified Rankin Scale – Grade 4). Based on Ayurvedic assessment, the condition was diagnosed as Avaranajanya Pakshaghata. Management was planned according to the underlying Samprapti and included Deepana–pachana and Rookshana measures for removal of Margavarana, followed by Vatahara and Brimhana therapies along with physiotherapy for 35 days. Significant clinical improvement was observed after treatment, with muscle power improving to 4/5 in the affected limbs, reduction in spasticity, improved gait, and better speech clarity. Functional assessment showed improvement in Barthel Index from 35 to 75 and Modified Rankin Scale from Grade 4 to Grade 3. The findings suggest that a structured Ayurvedic approach based on Samprapti, combined with physiotherapy, may contribute to meaningful functional recovery in post-stroke hemiplegia.