Abstract

MANAGING HEREDITARY SPASTIC PARAPLEGIA WITH MATRA BASTI: A CASE STUDY

Dr. Amulya G. V.*, Dr. Surya S. and Dr. Ananta S. Desai

ABSTRACT

Hereditary Spastic Paraplegia (HSP) is a clinical diagnostic designation for those neurologic syndromes in which bilateral lower extremity weakness and spasticity are predominant. In its pure form, HSP is usually transmitted as an autosomal trait. Symptoms of HSP usually begin in the third or fourth decade. Any early onset should include Cerebral Palsy in differential diagnosis. HSP typically has a long survival, presumably because respiratory function is spared. A 27 year old female approaches the OPD of SJIIM, Bengaluru and presents with low back ache which developed 8 years ago and is associated with numbness in left lower limb. The patient also complained of generalised weakness and instability while walking. Family history revealed her maternal aunt and younger sister to be having the same complaints. Along with these symptoms, she also had amenorrhoea since 6 months, white discharge per vagina, loss of appetite, and difficulty in passing stools. Reflexes of all cranial nerves were found to be normal. On motor system examination, patient exhibited scissors gait and found it difficult to maintain balance while walking. Direct reference of HSP cannot be found in Ayurveda classics but it can be interpreted as a Vata Vyadhi and is afflicted by beeja dosha. Considering the symptoms, it can be found that both Vyana Vayu and Apana Vayu are deranged. At the end of the course of the treatment, the patient’s lower limbs were assessed for changes in spasticity using Modified Ashworth Scale and there was a significant improvement as shown. Being an inherited condition, HSP cannot be guaranteed for a complete cure. However, owing to normal life expectancy in this condition, our treatment needs to be aimed at improving the quality of life. A comprehensive treatment should essentially include counselling of the patient as well as the family members.

Keywords: Hereditary Spastic Paraplegia, Vata Vyadhi, Matra Basti, Mahakukkutamamsa taila, beeja dosha.