Article by Dr MS Krishnamurthy MD (Ayu) Ph.D (Ayu) and Dr Hebbar.
Facial paralysis is resulted due to partial or complete loss of functions of facial nerve. Due to this the face is turned to the side opposite to the nerve which is affected. Infection and injury are the two common reasons for facial paralysis. Whereas age old Ayurveda system of medicine denotes some specific and minute reasons for the manifestation of this condition.
Even though all these may lead into the infection and injury as cited by modern medicine, understanding the basic causes for the illness help us to prevention / proper treatment of facial paralysis.
Ayurvedic text books refer facial paralysis with the name ‘Ardita’. Word meaning of Ardita is – ‘the condition caused due to unusual (vitiated/shifted/took the opposite pathway) function of Vata, which turns the mouth/face in opposite direction’.
Causes for facial paralysis as listed in Ayurveda:
1. Speaking loudly/higher pitch – over a long period of time
2. Intake/mastication of hard substances
3. Excess laugh
4. Constant yawning
5. Heavy weight bearing
6. Improper sitting/lying posture
7. Injury to the veins, arteries and nerves of the face
8. Day sleep
9. Tongue scraping (vigorous)
10. Long standing ulcers
11. Hit by animals (like elephant)
12. Improper venepuncture
13. Injury to the vital points (marma)
14. Constant rubbing or irritation of eyes, ears, nose etc
15. Intake of alcohol and fermented beverages
16. Suppression of natural urges (like sneezing, lacrimation etc) etc
Pathology of facial paralysis (Ardita) as per Ayurveda:
Due to above said factors, Vata is vitiated and lodge (occluded) in the corresponding nerves, arteries and veins, situated in the face. This declines the functioning of the nerves of the nearby area. Thus, the face is turned to one of the sides and the condition Ardita is resulted.
Important clinical features of facial palsy:
1. Turning of the face to any of the sides
2. Loss of function which are carried with the help of facial muscles and nerves
3. Numbness or pain in head, nose, lips, cheeks, forehead, eyes etc
4. Pain in the corresponding joints of the face
5. Deviation of the neck to any of the sides etc
Prodromal symptoms of facial paralysis, as per Ayurveda:
1. Shivering of the head
2. Stuttering/difficulty in speech
3. Discomfort in the eyes, nose and mouth
4. Pain in neck, cheeks, teeth or corresponding area
7. Turbidity of the eyes
8. Numbness of the skin (loss of tactile sensation in the affected area)
9. Sleep disturbance
10. Pricking sensation-occasionally
11. Stiffness of the neck muscles and jaw etc
Classification, specific features
Facial paralysis due to Vata imbalance:
Nausea, shivering, pulsation, lock jaw, edema over the lips, pain in the specific parts of the face etc
Ardita due to Pitta imbalance:
Yellowish discoloration of the face, fever, thirst, syncope, sensation of fumigation etc
Facial paralysis due to Kapha imbalance:
Edema over the hair margin, cheeks, face and neck, stiffness of the muscles etc
Line of treatment
Line of treatment of Facial paralysis:
Mridu swedana (mild sweating treatment),
Nasya (errhines, Nasal drops),
Snigdha-Amla-Lavana rasa Prayoga (administration of medicaments possessing unctuousness, sour and salt taste) and
Vatahara oushadha (Vata balancing medicine and treatment).
Single herbs useful in facial palsy:
1. Lashuna-garlic for facial palsy – Garlic is a very good in normalizing Vata and clearing the body channels from obstructions. Garlic relieves also releives swelling pain. It stimulates facial nerves by improving blood circulation.
2. Nirgundi- Vitex negundo – is good to relieve nerve pain and to improve muscle strength. It is an ingredient of Nirgundyadi taila, Manasamitra Vataka which are widely used in neurological, psychological, blood vessel and muscle related conditions.
3. Eranda- Castor leaves and oil – Ricinus communis – One of the powerful herbs to balance Vata and improve nerve strength. Its leaves are heated and directly applied to relieve inflammation.
4. Lavanga –Clove- Syzygium aromaticum – Regular intake of 3 – 4 drops of clove oil helps to strengthen nerves
5. Sarshapa- Mustard – Mustard oil is hot and piercing in nature. If the palsy is caused due to blockage of artery and after the routine treatments, to avoid further blockage and to improve local blood circulation, mustard – internal usage and mustard oil for massage is useful. But because mustard oil is quite hot in nature, care should be taken during massaging near eyes. If the patient does not tolerate raw mustard oil, it can be mixed in 50:50 along with Ayurvedic oils for palsy like Prasarini taila
6. Rasna- Alpinia galanga – powerful Vata balancing herb
7. Masha- Blackgram – black gram is known for its Vata balancing and nourishing qualities. If the paralysis is caused due to weak nerves, then black gram can be used in form of many dishes and Its oil Mahamasha tailam can also be used.
8. Bala- Sida cordifolia – one of the prime herbs to balance Vata.
9. Hingu-Asa foetida
10. Guggulu- Guggulu resin- Commiphora mukul
Ayurvedic medicines useful in Facial paralysis:
Medicines for External application:
1. Fine paste of clove, mustard, nirgundi leaves and eranda leaves is applied 20 minutes before bath. Is helpful to stimulate nerves, to improve blood circulation and to relieve pain and inflammation (if any).
2. Karpasathyadi taila – This oil is used for Basti (oil enema), Shirodhara and massage in all cases of paralysis.
3. Mahanarayana taila – used for oral intake (5 – 10 drops per day) and also for enema, massage etc. in case of palsy caused due to facial nerve weakness.
4. Mahamasha taila
5. Saindhavadi taila – especially used in paralysis caused due to blood vessel blockage. To clear the body channels and to improve circulation.
6. Laghuvishagarbha taila and Vishagarbha taila – useful where stiffness is a striking feature.
7. Prasarini taila
8. Vijayabhairava taila
Oral Ayurvedic medicines for Facial palsy:
1. Mahayogaraja guggulu
2. Ekangaveera rasa
3. Rasona pinda – garlic is the main ingredient
4. Maharasnadi kwatha
5. Rasnadi guggulu
6. Dashamoola rasayana
Wholesome diet and habits
1. Warm water
2. Lukewarm milk
3. Black gram
5. Red rice
9. meatsoup etc
Unwholesome diet and habits
1. Etiological factors
2. Stress and strain
3. Bitter and dry substances
4. Fried eatables
5. Work exhaustion
Facial paralysis is a Vata imbalance disorder, often associated with Pitta and Kapha. Now a days, antibiotics and vitamin supplements are given to pacify the complaint. Even though the patients get relief from these, the chances of repeated attacks are observed in my clinical practice.
During an attack of facial palsy it makes sense to take the patient to a nursing home to undergo investigations to know the real cause – internal hemorrhage, nerve damage etc. Once after the treatment is completed, Ayurvedic measures can be adopted for
1. Gradual recovery of facial muscle strength
2. Soothing and strengthening of nerves
3. Improve blood circulation
4. Prevention of recurrence.