Primary lateral sclerosis
(PLS) forms part of a group of diseases known as motor neuron disease, in which
the nerve cells controlling voluntary muscles degenerate and die, causing a
progressive muscular weakness. A similar
condition, known as Amyotrophic Lateral Sclerosis (ALS), is usually hereditary,
affects both upper and lower motor neurons, and can be fatal in the long run. Unlike ALS, PLS affects only upper motor
neurons, and is considered hereditary only if it occurs in childhood. Though rare, some patients with PLS have been
observed to gradually convert over time to ALS.
Common symptoms for
PLS include imbalance, weakness, clumsiness, muscle cramps and pain,
spasticity, speech and swallowing difficulties, difficulty in breathing,
hyper-reflexia, emotional labiality, bladder urgency, and occasionally,
cognitive changes. Symptoms usually
commence from the lower extremities and may gradually progress to the upper
extremities. The onset of symptoms is
usually after 50 years of age, with a gradual progression over several
decades. There are currently no specific
tests which are diagnostic of this condition.
A diagnosis is usually made by exclusion of other possible diseases, and
long-term observation.
Ayurvedic herbal treatment
is similar for all motor neuron diseases.
The management of PLS includes the use of herbal medicines which have a
specific action on the brain and the central nervous system. Additionally, medicines which act on the
neuromuscular junctions as well as the muscles and tendons are also very useful
in the management of this condition. A
combination of medicines acting on the nerves as well as on muscles brings
about the maximum possible benefit at the earliest. The dosage of medicines needs to be progressively
increased - subject to patient tolerance - over a period of several months, in
order to bring about the maximum possible therapeutic benefit.
Herbal medicines
which are useful in the management of PLS include Ashwagandha (Withania somnifera),
Shatavari (Asparagus racemosus), Bala (Sida cordifolia), Yashtimadhuk
(Glycyrrhiza glabra), Haridra (Curcuma longa), Shankhapushpi (Convolvulus pluricaulis),
and Brahmi (Bacopa monnieri). Herbal
combinations and herbo-mineral medicines useful in the management of this
condition include Bruhat Vat Chintamani, Maha Vat Vidhvans Ras, Khanj Nikari
Ras, Vasant Kusumakar Ras, Vishtinduk Vati, Heerak Bhasma, Trivanga Bhasma,
Triphala Guggulu, Trayodashang Guggulu, Panchatikta Ghruta Guggulu, and Sameerpannag
Ras.
Oral treatment can also
be supplemented with localized therapy in the form of full body massage using
medicated oils, followed by steam fomentation using medicated decoctions. Medicated
oils useful for massage include Maha Narayan oil, Maha Mashadi oil, and Maha Saindhavadi
oil. Medicated decoctions for steam
fomentation are usually prepared from medicines like Nirgundi (Vitex negundo), Rasna
(Pluchea lanceolata) and Dashmool (Ten herbal roots).
Depending upon the
chronicity and severity of symptoms, treatment needs to be given for periods
ranging from 12 to 24 months. Long-term,
high dose herbal treatment can stabilize symptoms, reduce disability, bring
about a gradual remission of the disease, prevent further deterioration,
improve quality of life, and significantly increase the overall life span of affected
individuals. Ayurvedic herbal treatment thus
has a significant role to play in the management and treatment of PLS.
The writer, Dr. A. A.
Mundewadi, is available as an online Ayurvedic Consultant at www.ayurvedaphysician.com
