Case Study: Successful Management of Acute Trigeminal Neuralgia

Introduction

Trigeminal neuralgia (TN) is a severe neuropathic condition characterized by intense, episodic facial pain. It can significantly impact daily activities such as eating, drinking, and even speaking. Conventional treatments often rely on medications like NSAIDs and anticonvulsants, but their efficacy varies. This case study highlights how a unique combination of Ayurveda, Panchakarma, and physiotherapy at Kerala Ayurvedic & Advanced Physiotherapy Centre, Bhopal, successfully managed a case of acute trigeminal neuralgia in a 28-year-old female patient.

Understanding Trigeminal Neuralgia

Trigeminal neuralgia is a chronic pain disorder affecting the trigeminal nerve, responsible for facial sensation. The condition presents as severe, sudden, shock-like pain that may be triggered by routine activities such as chewing or brushing teeth. While structural abnormalities or nerve compression can be detected in some cases via MRI, others, like this case, remain idiopathic despite exhibiting severe symptoms.

Ayurvedic View

Considering the symptoms, in this case, trigeminal neuralgia can be correlated to Anantavata, a type of Shiroroga caused by the vitiation of the three doshas. The treatment protocol includes raktamoksha, nasya, lepa, anjana, etc and Vata & Pitta-mitigating food.

Case Details

A 28-year-old female presented with a gradual onset of shooting pain above the upper lip, adjacent to the right nostril. Over time, the pain radiated to the right cheek, accompanied by visible swelling. Within a week, the pain became excruciating (8/10 on the Wong-Baker Faces Pain Rating Scale), making daily activities like eating, drinking, and brushing unbearable. Despite an initial diagnosis of trigeminal neuralgia by a neurologist, MRI results showed no nerve damage or obstruction. Conventional NSAID treatment failed to provide relief, prompting the patient to seek alternative therapy at Kerala Ayurvedic & Advanced Physiotherapy Centre.

Treatment Approach

A holistic, integrative treatment plan combining Ayurveda, Panchakarma, and physiotherapy was developed. The treatment was executed in two major phases:

Phase 1: Symptomatic Relief with Ayurveda and Physiotherapy

  • Classic Ayurvedic herbal formulations were prescribed internally for ten days.
  • Physiotherapy treatment included Class IV cold laser therapy and combination therapy.
  • By the third day, the patient’s pain scale had reduced to 6/10.
  • By the fifth day, the pain had further diminished to 4/10.
  • By the tenth day, the pain scale reached 2/10, though occasional shooting pain persisted.

Phase 2: Panchakarma - Ayurvedic Detoxification and Rejuvenation

  • Internal medicines were discontinued, and a structured detoxification process began.
  • Virechana (Therapeutic Purgation) was performed after a preparatory phase involving Achasnehapanam (internal oleation) for seven days, followed by Abhyanga Swedanam (oil massage and steam therapy).
  • Nasya Therapy (Nasal Medication) was initiated post-Samsarjana Krama (post-detox diet) for seven days.
  • Following these treatments, the frequency of sudden shooting pain decreased significantly, with a complete resolution of pain (0/10 pain scale).
  • The patient was prescribed follow-up medications and advised Mukhabyangam (facial massage) and Marsha Nasya (Nasal Medication) for home care.

Outcome

After two weeks, the patient reported no pain or recurrence of shooting sensations. The integrative approach of Ayurveda, Panchakarma, and physiotherapy not only alleviated symptoms but also prevented recurrence, highlighting the efficacy of combining traditional wisdom with advanced technology.

Conclusion

This case study demonstrates the potential of integrative medicine in treating neurological conditions like trigeminal neuralgia. By leveraging Ayurvedic detoxification therapies, Panchakarma, and modern physiotherapy techniques at the Kerala Ayurvedic & Advanced Physiotherapy Centre, significant pain relief and long-term recovery were achieved. This success story underscores the importance of a multidisciplinary approach in managing complex neuropathic disorders.