Ayurvedic Management of Psychogenic Nonepileptic Seizures - A Case Report

Abstract

ABSTRACT Psychogenic nonepileptic seizures (PNES) are characterized by paroxysmal changes in behavior, consciousness, and autonomic function that resemble epileptic seizures (ES). Disturbances of motor, sensory, autonomic, cognitive, and emotional functions could be seen in patients with PNES. PNES is a heterogeneous condition and has a very diverse etiology. Patients with PNES are often misdiagnosed and are exposed to unnecessary antiseizure medications. The present case report deals with a patient diagnosed of having PNES and opted Ayurvedic treatment for better and sustained relief. The purpose of presenting this clinical case report is to explain the difficulties that are generally involved in the Ayurvedic diagnosis and management of PNES. Yoshapasmara or Yoshapatantraka is not a reliable and authentic Ayurvedic diagnostic entity for PNES. The comorbidity of ES and PNES is well recognized in Ayurveda. ES can be correlated with Doshaja Apasmara and PNES with Agantuja Apasmara. The Doshaja and Agantuja Apasmaras are not the discrete, independent diagnostic entities; rather, they are at the both ends of the same spectrum. The patient was diagnosed as having Agantuja Apasmara, treated with Ayurvedic medicines (Saraswata Choorna and Panchagavya Ghrita) and procedures (Nasya and Dhoomapana). The patient got clinically meaningful improvement with Ayurvedic treatment protocol, especially in headache, seizure episodes, and in depressed mood. Agantuja Apasmara is the most suitable Ayurvedic diagnosis for PNES and Ayurvedic treatment seems to be promising in the management of PNES. The present study findings cannot be generalized and further clinical trials with large sample size and with long term follow-up are required.