Effect of Vachalasunadi Tailam as Mukhabhyanga and Shiroabhyanga in Sialorrhea of Children with Cerebral Palsy Aged 4-12 Years

Abstract

Sialorrhea in children with cerebral palsy arises from oro-facial neuromuscular dysfunction. In Ayurveda, this presentation is understood as Lalasrava (salivation) or Praseka (excessive salivation), driven by Kapha (phlegm) Avarana (occlusion) obstructing Prana and Vyana Vayu (types of bodily air) within the oral cavity (Mukha Sthana). This single-arm, prospective, pre-post clinical trial enrolled 24 pediatric participants aged 4–12 years with a confirmed diagnosis of cerebral palsy and frequent anterior drooling (CTRI/2023/11/059985) to evaluate the clinical efficacy of Vachalasunadi Tailam (medicated herbal oil) administered via combined Mukhabhyanga (facial oil massage) and Shiroabhyanga (head oil massage). Vachalasunadi Tailam was administered once daily at home by trained parents for 21 consecutive days (5ml for Mukhabhyanga with orofacial stimulation; 2.5ml for Shiroabhyanga). Primary outcomes were evaluated at baseline (day 0), post-intervention (day 22), and follow-up (day 53) using the Drooling Quotient-Five Minutes and the Drooling Questionnaire for Indian children with cerebral palsy. Pairwise comparisons of both assessment tools showed a highly significant reduction in drooling frequency and severity from baseline to day 22 (p<0.01). This therapeutic effect was sustained at the day 53 follow-up (p<0.01) with zero reported adverse drug reactions. Combined Mukhabhyanga and Shiroabhyanga with Vachalasunadi Tailam is a safe, effective home intervention that achieves Vata Anulomana (regularization of nervous impulses), systematically clears Kapha Avarana, improves oro-motor coordination, and enhances quality of life.