Pishacha grahonmada – Frontotemporal dementia with Vitamin B12 deficiency?

Abstract

Description of 18 types of bhutonmada or grahonmada (psychiatric diseases caused by idiopathic factors) has been documented by Maharshi Vagbhata. Pischacha grahonmada (PG) is one among those 18 types. No works are available on PG till date. The concept of PG and its clinical application is unclear due to the scarcity of published literature on this topic. The aim of the present study is to explore the condition of PG in terms of contemporary psychiatric literature. Ayurvedic literature pertaining to “Pishacha grahonmada” has been collected from major classical Ayurvedic texts and their commentaries. Electronic databases have been searched to find out the relevant psychiatric and/or neuropsychiatric conditions which are similar to PG by using relevant keywords. PG is characterized by clinical features like Aswastha chittam (feeling uneasy), naikatra tishtantam (unable to sit at one place), paridhaavinam (wandering/pacing/running), dayita nritya geeta haasa ucchishta ratim (hypomania or mania like features), madya maamsa ratim (fond of eating meat, alcohol abuse), shunya nivaasa ratim (staying alone/social withdrawal), nirbhartsanaat (threatening others), deena shankita vadanam (depression with suspiciousness), nakhai aatma vapushi likhantam (self-injurious behavior with nails), nashta smriti (memory loss), baddhaabaddha bhaashinam (irrelevant speech), akasmaat rudantam (crying suddenly), dukhaani aavedayamaana (sharing his sorrows to everyone)/dukhaani avedayamaana (unable to feel pain), uddhvasta (nakedness), rooksha deha and swara (rough emaciated body and voice), durgandham/ashuchi (unhygienic), rathya chaila trina aabharanam (gross abnormal behavior), and bahvaashinam (hyperphagia). “Nashta smriti” is the unique symptom of PG and it denotes memory impairment commonly seen in conditions like dementia. The clinical features of PG have shown similarity with “Frontotemporal dementia” associated with malnutrition and/or Vitamin B12 deficiency. The present study provides inputs for future research works.