E-ISSN:2456-3110

Case Report

Motor Neuron Disorder

Journal of Ayurveda and Integrated Medical Sciences

2025 Volume 10 Number 5 MAY
Publisherwww.maharshicharaka.in

Ayurvedic management of Motor Neuron Disorder (Mamsa Majjagata Sarvanga Vata) - A Case Report

Totad M1*, Rout S2, Vasantha B3, Navyshree MS4
DOI:10.21760/jaims.10.5.41

1* Muttappa Totad, PhD Scholar, Dept of Kayachikitsa, Sri Jayendra Saraswathi Ayurveda College and Hospital, Nazarathpet, Chennai and Professor, Dept of Kayachikitsa, Sri Dharmasthala Manjunatheshwara College of Ayurveda and Hospital, Hassan, Karnataka, India.

2 Suvendu Rout, Professor, Dept of Kayachikitsa, Sri Jayendra Saraswathi Ayurveda College and Hospital, Nazarathpet, Chennai, Tamil Nadu, India.

3 Vasantha B, PhD Scholar, Dept of Kayachikitsa, Sri Jayendra Saraswathi Ayurveda College and Hospital, Nazarathpet, Chennai and Associate Professor, Dept of Kayachikitsa, Sri Dharmasthala Manjunatheshwara College of Ayurveda and Hospital, Hassan, Karnataka, India.

4 Navyshree MS, Post Graduate Scholar, Dept of Kayachikitsa, Sri Dharmasthala Manjunatheshwara College of Ayurveda and Hospital, Hassan, Karnataka, India.

Motor neuron disorders are a group of progressive neurological diseases that affect motor neurons. As motor neurons degenerate, the brain's ability to initiate and control muscle movements diminishes, leading to severe disability and, eventually, death. A 52-year-old male patient apparently healthy 1 year ago, gradually over a period of 6-7 months patient experienced reduction of strength in bilateral lower and upper limb, slurred speech, fasciculation over thigh region. Patient observed progression of the above symptoms which made him unable to stand and walk without support, difficulty in swallowing. Patient visited National Institute of Mental Health and Neurosciences, Bengaluru where magnetic resonance imaging of brain (impression: Grade 1 small vessel ischemic changes) and electromyography were done (impression: preganglionic neurogenic involvement of bulbar, cervical, thoracic and lumbar segments with evidence of ongoing denervation and chronic re-nervation: likely pathology-anterior horn cell). Diagnosed it as motor neuron disorder advised medications and physiotherapy (for 6 months). Later, after 1 year, patient visited SDM Ayurveda hospital 11.11.2024. Here, this was diagnosed as Mamsa-Majjagata Sarvanga Vata, based on the symptoms Bala Kshaya/Chesta Nivrutti (reduced strength), Vak Stamba (difficulty speaking), Mamsa Kshaya (muscle wasting). Patient was treated for 20 days with Ayurveda according to stages of the disease (Ama, Kapha Dosha, and Vata). Sarvanga Kayaseka, Agnichikitsa Lepa, Ksheera Vaitarana Basti, Brihat Vata Chintamani Rasa, Saraswatharishta, Agnitundi Vati, Vak Shuddhikara Choorna, and physiotherapy were adopted. Assessed for changes in clinical features, Medical Research Council muscle scale for strength, Barthel Index. These assessments were shown significant improvements.

Keywords: Mamsa Majjagata Vata, Motor neuron disorder, Sarvanga Vata, Shamana Medications, Basti

Corresponding Author How to Cite this Article To Browse
Muttappa Totad, PhD Scholar, Dept of Kayachikitsa, Sri Jayendra Saraswathi Ayurveda College and Hospital, Nazarathpet, Chennai and Professor, Dept of Kayachikitsa, Sri Dharmasthala Manjunatheshwara College of Ayurveda and Hospital, Hassan, Karnataka, India.
Email: 		Totad M, Rout S, Vasantha B, Navyshree MS, Ayurvedic management of Motor Neuron Disorder (Mamsa Majjagata Sarvanga Vata) - A Case Report. J Ayu Int Med Sci. 2025;10(5):263-268.
Available From
https://jaims.in/jaims/article/view/4310/

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2025-04-12 2025-04-26 2025-05-07 2025-05-17 2025-05-27
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None Nil Not required 11.65

© 2025 by Totad M, Rout S, Vasantha B, Navyshree MS and Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

J Ayu Int Med Sci 2025;10(5)263
Download PDFBack To ArticleIntroductionCase ReportResultDiscussionConclusionReferences
Muttappa T et al. Ayurvedic management of Motor Neuron Disorder

Introduction

Motor neuron disorders (MND)[1] is a group of progressive neurological diseases that affect motor neurons.

The most common form, Amyotrophic Lateral Sclerosis (ALS), causes gradual deterioration of muscle function, impacting movement, speech, swallowing, and breathing.

As motor neurons degenerate, the brain's ability to initiate and control muscle movements diminishes, leading to severe disability and, eventually, death. Patient visited National Institute of Mental Health and Neurosciences, Bengaluru where magnetic resonance imaging (MRI) of brain and electromyography (EMG) were done.

Diagnosed it as motor neuron disorder advised medications and physiotherapy (for 6 months). Here, we diagnosed it as Mamsa-Majjagata[2] Sarvanga Vata[3], based on the symptoms Bala Kshaya/Chesta Nivrutti (reduced strength), Vak Stamba (difficulty speaking), Mamsa Kshaya (muscle wasting).

Patient was treated for 20 days with Ayurveda according to stages of the disease (Ama, Kapha Dosha and Vata). Agnitundi Vati[4], Vak Shuddhikara Choorna[5], Chandraprabha Vati[6], Saraswatharishta[7], Brihat Vata Chintamani Rasa[8], Kalyanaka Ghrita[9], Sarvanga Kayaseka, Abhyanga[10], Agnichikitsa Lepa, Ksheera Vaitarana Basti, and physiotherapy were adopted.

Assessed for changes in clinical features, Medical Research Council muscle scale for strength, Barthel Index. These assessments were shown significant improvements.

Case Report

Aatura Parichaya

  • Age: 52 years
  • Gender: male
  • Religion: Hindu
  • Socio economic status: Middle class
  • Educational status: Degree
  • Occupation: Farmer
  • Marital status: Married

  • IPD number: 079364
  • Date of admission: 11/11/2024
  • Date of discharge: 30/11/2024
  • Source of history: Patient and patient wife

Pradahana Vedana

  • Reduced strength in bilateral (b/l) upper and lower limb since 1 year
  • Unable to stand without support since 3 months
  • Unable to walk with and without support since 2 months
  • Difficulty speaking- unable to utter “RA”,” UHH”,”PAH”,”GHA” since 2 months
  • Difficulty swallowing and breathing since 1 month
  • Brisk fasciculation over b/l thigh regions since 1month
  • Heaviness in the body since 1 month
  • Muscle wasting over thigh and b/l web spaces since 1 month

Vedana Vrittanta

A 52-year-old male patient apparently healthy 1 year ago, gradually over a period of 6-7 months patient experienced reduction of strength in bilateral lower and upper limb, slurred speech, fasciculation over thigh region.

Patient observed progression of the above symptoms which made him unable to stand and walk without support, difficulty in swallowing.

Patient visited National Institute of Mental Health and Neurosciences, Bengaluru. Diagnosed it as motor neuron disorder advised medications and physiotherapy (for 6 months).

Recently, he started to suffer with breathing difficulty on supine position, muscle wasting along with above complaints. Later, after 1 year, patient visited SDM Ayurveda hospital on 11.11.2024.

Vayaktika Vrittanta

Diet: Mixed diet (non-veg once a week)
Appetite: Reduced
Bowel: Regular (once /day)
Sleep: Adequate (lateral or sitting position)
Micturition: 4-5 times / day


J Ayu Int Med Sci 2025;10(5)264
Muttappa T et al. Ayurvedic management of Motor Neuron Disorder

General Examination (clinical findings)

  • Nourishment: Moderate
  • Built: Moderate built
  • Cyanosis: Absent
  • Lymphadenopathy: Absent
  • Tongue: Coated
  • Edema: Absent
  • Pallor: Absent
  • Temperature: 97.6°F
  • Icterus: Absent
  • Blood pressure: 120/80 mmhg
  • Clubbing: Absent
  • Heart rate: 78 beats per min
  • Respiratory rate: 20 cycles per min

Examination

  • CNS - conscious and oriented to person, place and time
  • CVS - S1S2 heard, no murmurs
  • RS - Chest clear, no crepitation

Cranial Nerve

  • Smell - intact
  • Visual acuity - 6/6 b/l eye
  • Pupil b/l equal and reacting to light
  • EOM - full in all direction, no nystagmus
  • Fundus - b/l normal
  • Mild bifacial weakness +
  • Gag reflex b/l ++
  • Tongue Fasciculation ++

Motor System

  • Diffuse fasciculation over b/l thighs, tongue
  • Power - 3/5 B/L upper and lower limb
  • Hand grip - 4/5
  • Tone - hypotonic
  • Reflexes - exaggerated
  • Sensory - fine touch and pin prick normal
  • Gait - not elicited (patient was not able to walk)

Ashthasthana Pariksha

  • Nadi - Vataj
  • Mala - Niram
  • Mutra - Samanya
  • Jiwha - Saama
  • Drik - Samanya
  • Shabda - Ksheena
  • Sparsha - Ruksha
  • Akruti - Ksheena

Dashavidha Pareeksha

  • Prakruthi - Vata-Kapha
  • Vikruthi - Vata and Kapha, Dooshya - Rasa, Rakta, Mamsa, Medha, Asthi, Snayu
  • Sara - Madhyama
  • Samhanana - Madhyama
  • Pramana - Madhyama
  • Saatmya - Madhyama
  • Satva - Madhyama
  • Ahara Shakti and Abhyavarana Shakti - Avara, Jarana Shakti - Avara
  • Vyayama Shakti -Avara
  • Vaya - Madhyama

Prayogashalyeeya Pareeksha (Investigation done):

  • MRI brain - 29/4/2024: Grade 1 small vessel ischemic changes, Mild asymmetry of cerebral hemisphere.
  • EMG - 3/7/2024: Preganglionic neurogenic involvement of bulbar, cervical, thoracic and lumbar segments with e/o ongoing denervation and chronic re-nervation (likely pathology-anterior horn cell)
  • MRI WHOLE SPINE - 29/4/2024: Cervical and lumbar spondylosis, diffuse bulge in C5-C6, L4-L5, L5-S1levels.

Assessment Criteria

  • Clinical features,
  • Medical Research Council muscle scale for strength,
  • Barthel Index

J Ayu Int Med Sci 2025;10(5)265
Muttappa T et al. Ayurvedic management of Motor Neuron Disorder

Chikitsa Adopted (Interventions)

Table 1: Treatment with timeline adopted

DateTreatmentObservations
11/11/2024 to 15/11/2024
  • Sarvanga Kayasheka with Dashamoola Kashaya and Dhanyamla.
  • Upanaha to b/l knee with Jatamayadi Choorna and Parisheka Thaila
  • Vestana to b/l thighs with Parisheka Thaila
  • Agnitundi Vati 1 tid b/f (before food)
  • Chandraprabha Vati 1 tid a/f (after food)
  • Saraswatharistha 15 ml tid a/f
  • Vak Shooddhikara Choorna 3 gms tid to rub on tongue
  • Physiotherapy
On 15/11/2024
  • Tongue - ama (reduced)
  • Body heaviness reduced
  • Heaviness presents only on thighs
  • Speech improved
  • Breathlessness reduced
  • Fasciculations on tongue reduced
  • Fasciculations in left thigh reduced
  • Sleep on supine position
  • Able to stand without support (around 7 to 10 mins)
  • Difficulty swallowing reduced
16/11/2024 to 24/11/2024
  • Agnichikitsa Lepa for 30 mins on heaviness area (thighs)
  • Anuvasana Basti with Kalyanaka Ghrita 40 ml
  • Saraswatharistha 15 ml tid a/f
  • Vak Shooddhikara Choorna 3 gms tid to rub on tongue
  • Bruhata Chintamani Rasa (Suvarna Yukta) 1 at 6 pm with honey
  • Physiotherapy
On 24/11/2024
  • Heaviness of thighs reduced
  • Fasciculations in right thigh reduced
  • Able to walk with walker and one attender support (10-12 steps)
25/11/2024 to 20/11/2024
  • Ksheera Vaitarana Basti (Administered after lunch - Bhukte Deeyate) (V)
Niruha: Chincha - 50 ml, Guda - 25 ml, Saindhava - 5 gms, Ksheera - 50 ml, Ashwagandha Ghrita 20 ml + Ksheerabala Thaila 20 ml = 40 ml
Schedule:
25/1126/1127/1128/1129/11
VVVVV
  • Sarvanga Abhyanga with Ksheerabala Thaila and Shastika Shali Pinda Sweda
  • Saraswatharistha 15 ml tid a/f
  • Vak Shooddhikara Choorna 3 gms tid to rub on tongue
  • Bruhata Chintamani Rasa (Suvarna Yukta) 1 at 6 pm with honey
  • Physiotherapy
On 24/11/2024
  • Able to walk with walker (12-15 steps/bathroom)
  • Speech improved
  • Gait improved

Result

Table 2: Assessments

CriteriasBefore treatmentAfter treatments
Chesta Nivrutti/ Bala KshayaPresentImproved
MRC muscle strength scale3 (all limbs)4- (all limbs)
StandingUnable to standAble to stand without support
WalkUnable to walkAble to walk with walker
SpeechSlurred (1 or 2 words)Improved (sentences)
SwallowingDifficultNormal
Dyspnea (on supine)PresentAbsent
FasciculationPresentAbsent
Heaviness in the bodyPresentAbsent
Muscle wasting over thighs and b/l webPresentPresent
Barthel Index45 (partially dependent)65 (minimally dependent)

J Ayu Int Med Sci 2025;10(5)266
Muttappa T et al. Ayurvedic management of Motor Neuron Disorder

Discussion

Ayurveda treatments have demonstrated their effectiveness in managing Mamsa Majjagata Sarvanga Vata (~MND). Agnitundi Vati as Deepana, helped in this patient. Chandraprabha Vati has Kapha Hara, Medo Hara action. Heaviness was reduced. Agnichikitsa Lepa also reduced heaviness.

Sarvanga Kayaseka played a crucial role in opening the minute bodily channels (Srotas), enhancing blood and lymphatic circulation. This therapy alleviates Kapha and Vata imbalances, while removing obstructions (Avarana or Srotorodha/Ama), preparing the body for subsequent treatments such as Abhyanga (oil massage) and Basti (medicated enema).

Sarvanga Abhyanga, along with Baashpa Sweda (steam therapy) and Naadi Sweda (localized steam), may be reduced muscle spasticity, reduced fasciculations, increased joint flexibility, enhances circulation, and alleviates pain. Among these treatments,

Basti is considered the most significant for managing Sarvanga Vata, as it supports both gross and fine motor functions, nourishes tissues, and improves overall health and quality of life, particularly in patients with motor neuron disease (MND). Ksheera Vaitarana Basti is Ama/Kapha Hara and Vata Hara along with Brumhana quality (According to Vangasena), as this patient was having heaviness, Ama Lakshanas. As strength of patient was Avara. Vaitarana Basti after lunch was administered (Bhukte Api Deeyate)

Ksheerabala Thaila has Brumhana, Vatahara action, which helped in this patient. Ashwagandha Ghrita may be acted as a neuro-protective agent and possesses antioxidant properties. Saraswatharistha has Medya, Swarya action. This action helped in this patient as speech abnormality was there. Brihat Vata Chintamani Rasa (BVC Rasa) fortified with Swarnabhasma (gold ash) are known to enhance sensory and motor functions, support cognitive health, and offer immunomodulatory effects. Integrating physiotherapy into the treatment plan further aids in improving mobility and muscle strength, making it a vital component in the comprehensive management. Thus, Deepana, Amahara/Kaphahara, Vatahara, Mamsa Majjagata Vata Chikitsa,

Pakshaghata/Sarvanga Vata Chikitsa subsequently adopted (according to stage/Avastha) and resulted in significant improvement.

Conclusion

Ayurveda treatment protocol adopted in MND shown significant improvement in clinical features ~ muscle strength, speech, and gait. MND can be treated according to Kapha Avruta Vata, Mamsa Majja Gata Vata and Sarvanga Vata. Multicentric clinical trials can be conducted on MND with this Ayurved treatment protocol.

References

1. Sharma S, Chauhan N. Motor Neuron Disease: A Case Report with Review of Literature. Int Aca Res J Int Med Pub Hlth. 2022;3(3):20–1. [Crossref][PubMed][Google Scholar]

2. Tripathi B, editor. Charaka Samhita of Agnivesha. Chikitsa Sthana, 28/24–38. Reprint ed. Varanasi: Chaukhambha Surabharati Prakashana; 2009. p. 481 [Crossref][PubMed][Google Scholar]

3. Srikanta Murthy KR, editor. Ashtanga Hridaya. Vol II, Nidana Sthana, 15/16. Reprint ed. Varanasi: Chaukamba Krishnadas Academy; 2008. p. 150–1 [Crossref][PubMed][Google Scholar]

4. Shastri A, editor. Bhaishajya Ratnavali. Agnimandyadi Chikitsa Prakaranam (Agnitundi Vati). Varanasi: Chaukhambha Prakashan; 2019. p. 341 [Crossref][PubMed][Google Scholar]

5. Tripathi B, editor. Ashtanga Hridaya. Nirmal Hindi Commentary, Uttartantra, Balopacharaniya Adhyaya, Sloka 49. Delhi: Choukhamba Sanskrit Pratishthan; [year not provided]. [Crossref][PubMed][Google Scholar]

6. Lochan K, editor. Bhaishajya Ratnavali. Prameha Chikitsa, Vol. 2, Chp. 37. 1st ed. Varanasi: Chaukhambha Sanskrit Bhawan; [year not provided]. p. 521–2 [Crossref][PubMed][Google Scholar]

7. Shastri RV, editor. Bhaishajya Ratnavali. Atha Vajikarana Prakaranam (Saraswatarishta). Varanasi: Chaukhamba Sanskrit Bhawan; 2002. p. 796–7 [Crossref][PubMed][Google Scholar]


J Ayu Int Med Sci 2025;10(5)267
Muttappa T et al. Ayurvedic management of Motor Neuron Disorder

8. Mishra S, editor. Bhaishajya Ratnavali of Kaviraj Govind Das Sen. Brihat Vata Chintamani Rasa. Varanasi: Chaukhamba Surabharati Prakashana; 2009. p. 530 [Crossref][PubMed][Google Scholar]

9. Shastri K, Chaturvedi G, editors. Charaka Samhita of Agnivesha. Chikitsa Sthana, Ch. 9, Ver. 35–41 (Kalyanaka Ghrita). Reprint ed. Varanasi: Chaukhambha Bharti Academy; 2011. p. 318–9 [Crossref][PubMed][Google Scholar]

10. Sharma RK, editor. Charaka Samhita. Cha. Su. 5/85–86. Reprint ed. Varanasi: Chowkhamba Sanskrit Series Office; 2011 [Crossref][PubMed][Google Scholar]

Disclaimer / Publisher's Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of Journals and/or the editor(s). Journals and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.


J Ayu Int Med Sci 2025;10(5)268