MND (Motor Neurone Disease) Ayurvedic Treatment

These are a group of progressive disorders affecting motor neurons (nerve cells that control motor activities like breathing, swallowing, talking etc). In a normal person, the upper motor neurons (nerve cells in brain) send signals to lower motor neurons (at brain stem and spinal cord) and from there, these signals are transmitted to muscles. If the signals from lower motor neurons are interrupted, the muscles become weak and thinner (atrophy) and develops fasciculations (twitches). When the signals from upper motor neurons to lower motor neurons are interrupted, the muscles become stiff (spasticity) with exaggerated reflexes resulting in slow voluntary movements. Various types of MNDs are amyotrophic lateral sclerosis, progressive bulbar palsy, progressive muscular atrophy, spinal muscular atrophy, primary lateral sclerosis, Kennedy’s disease, and post-polio syndrome. Though most of the MNDs are inherited, what actually causes them is still unknown. Some cases develop without any family history (sporadic). The possible reasons of non-inherited MNDs are toxicities, infections, environmental factors etc.

MND (Motor Neurone Disease) Signs and Symptoms

The signs and symptoms of MNDs differs depending on the type. The common features are muscle weakness and disabilities. The major types and their symptoms include:

Amyotrophic lateral sclerosis/ ALS (Classical motor neuron disease)- both upper and lower motor neurons are affected and the person suddenly loss muscle control and gradually develops paralysis. At first, a single limb or muscles of throat or mouth become weak or spastic and gradually involve other voluntary muscles. Eventually, there will be difficulty to speak, chew, breath etc.
Progressive bulbar palsy/ PBP (Progressive bulbar atrophy)– here, the lower motor neurons connected to brain stem (bulbar region) are affected. Bulbar region controls speaking, chewing, swallowing etc and hence these activities are impaired due to PBP. Other symptoms are weakness of facial muscles, inner arms and thighs, reduced gag reflex, muscle twitches, emotional lability (inappropriate laugh or cry) etc.
Primary lateral sclerosis (PLS)– slow or difficult movements of arms, legs, facial muscles due to impaired upper motor neurons. The weakness starts at lower limbs, and then progress to torso, arms, hands, facial muscles. Finally, the person develops difficulty to chew, speak, swallow etc. The risk of fall is more in this type of MND. Emotional disturbances are also a common feature.
Progressive muscular atrophy/ PMA– though rare, this condition causes progressive weakening of lower motor neurons. The symptoms first appear on hands and then involve lower body, which include muscle twitches and wasting, cramps, clumsy hand movements etc. These problems worsen with exposure to cold.
Spinal muscular atrophy/ SMA– is the common genetic cause of infant death. It is an inherited condition affecting lower motor neurons. Muscle weakness is more towards the centre of the body (eg: torso. Thighs etc). In SMARD1 (Spinal Muscular Atrophy with Respiratory Distress type 1, develops in infants (below 6 months of age) characterised by sudden breathing difficulty. Congenital SMA with arthrogryposis appears from birth and the baby shows inability to move affected limb, muscle contractions, chest deformity, difficulty to breath, scoliosis, drooping of eyelids etc.

Kennedy’s disease/ bulbospinal muscular atrophy– affects men (their daughters are carriers of the disease). Early symptoms are tremor of outstretched hands, muscle cramps while doing physical activities, muscle twitches etc. Gradually, muscle weakness (of tongue, jaw etc) develops resulting in difficulty to speak/ chew/ swallow, and then progress to lower body with weakness of pelvic muscles, legs etc, pain and numbness of arms and legs etc.

Post-polio syndrome/ PPS– affects polio survivors after many years. Common symptoms are fatigue, cold intolerance, muscle weakness, twitches, and atrophy of the same muscle group affected with polio, sleeplessness, difficulty to swallow and breath etc.

MND (Motor Neurone Disease) Ayurvedic Analysis

Aggravated vata produces several symptoms and signs like fatigue, joint and muscle stiffness (anga graha), reduced range of motion, muscle atrophy and weakness (mamsa kshaya), cold intolerance (sheeta asahishnuta), kampa (muscle twitches), problems with speaking (vak graha)/ chewing (hanu graha) etc. Vyana, udana and prana (types of vata) are vitiated here which affect mamsa dhatu (muscle tissue) and sira (nerves and blood vessels).

MND (Motor Neurone Disease) Causative Factors (Ayurveda)

Common causes of vata vruddhi are trauma, infections, beejadushti (genetic factors), excess physical activity, exposure to cold, long travel, suppression of natural urges like sneezing/ yawning, bearing heavy weight over the head or shoulders etc.

Possible Complications of MND (Motor Neurone Disease) Disease

In ALS, respiratory failure occurs which results in death. Choking and aspiration of food or saliva into lungs are the complications in PBP. Common complications are uncontrollable emotions (pseudobulbar effect), cognitive dysfunction, difficulty to perform daily activities, sleeplessness, paralysis etc.

Other systemic diseases and precautions to be taken

Rule out myasthenia gravis, stroke etc before planning treatment.

MND (Motor Neurone Disease) Disease Management with Ayurveda Treatment

Treatment is focused on pacifying vata and slowing down mamsa kshaya. Internal medicines are given that can improve functioning of brain and nerve cells, pacify vata and reduce muscle weakness. Along with this, procedures like snehana (internal/ external/ both), swedana (mild sudation therapy like pizhichil), nasya (nasal instillation of medicine), virechana (purgation), shirovasthi (retention of medicine over the scalp), vasthi (enema with suitable drugs), brumhana (nourishment therapy like njavara kizhi), rasayana chikilsa (rejuvenation therapy) etc are provided. Supportive treatments like physiotherapy, yoga, and psychotherapy are beneficial.

Diet

Consume semi-solid or liquid diet. Include more vegetables, whole grains, fruits, meat soups etc in diet. Avoid the consumption of cold, dry, light food.

Exercise

Mild exercises can be done with support. Yoga, pranayama and meditation are helpful.

MND (Motor Neurone Disease) Preventive Aspects in Ayurveda

Though the condition is not preventable, efforts to maintain vata in normal state may help a lot. They include:

Avoid excess physical activity, bearing weight over the head or shoulders, travelling continuously, altered sleep pattern, talking loudly for long time etc.
Ensure adequate rest.
Take healthy food.
Avoid day sleep.
Apply suitable oil over the body and massage well.
Avoid chances of infection, injuries etc.