Tropical Spastic Para Paresis and Ayurveda

Material

Patients of proved and treated cases of Tropical spastic Para paresis without any clinical response, attending at Centre For Critical Care, National Institute of Health & Research were considered for evaluation of the herbal neurogenic constituting therapeutic regime.

Methods

Patients of spastic para paresis diagnosed by myelogram, computerized tomography(CT) and magnetic resonance imaging (MRI) been interrogated thoroughly for the onset, duration and evolution of the disease, Family history of neurological illness, history of extramarital sexual exposure, abortion, blood transfusions, dietary with emphasis on strict vegetarianism, Lathyrus sativus, Socio-economic status, housing , sanitary conditions, treatment taken and their response. A detailed general examination and a meticulous neurological assessment were done (Table 1).

fasting and postprandial blood sugar, renal and liver function tests, and serological test for syphilis (Table 2).

All patients underwent conventional myelography CT and MRI scans. The serum samples of all the patients were tested for HTLV-1 antibodies by the serodia technique. All patients presenting with this crippling disease were advised and administered the following therapeutic regime after due awareness counselling and encouragement-

• Inj Calcium gluconate 1amp every 15th day intravenous very slow
• Inj Methyl cobalamine +Pyridoxin +Niacinamide +Pantothenic acid + Betamethasone every week
• Inj Self blood +Betamethasone 2mg every 10th day intramuscular
• Cap Vitamin D3 60 K every week orally
• Syrup NEUROVIT 10 ml every 12 hours /Cap NEUROVIT 1 cap every 12 hours
• Active and passive exercise of the extremity
• Diet: High Protein vegetarian diet Herbal composite NEUROVIT Syr or Capsule constitutes-Cap 500mg Or Syr. 5ml constitutes 100mg each of Acorus calamua (rhizome), Nardostachys jatamansi (Flower), Herpestis monnieri (leaf), Convolvulus pluricaulis (flower), Cassia acutifolia (seed) Patients were assessed for improvement in tone and power of the muscle, tingling and numbness, gait, and autonomic function (passage of stool and urine) for which patients were given a follow up card to mention date of achievement and any untoward manifestation experienced .Patients were advised to visit the center on any unusual manifestation or contact on helpline for needful redresses. To adjudge the safety profile of the regime practiced basic bio parameters were repeated every month for first three month and then every 3 months (Table 3).

63 identified, diagnosed and treated Patients of Tropical spastic para paresis considered for study were of age group 30-50 years and out of them majority (30/63) were of age group 30-35 years with female dominance (Table 4, Figure 1) and all were from rural background and community representation was (Figure 2). Out of all majorities were non vegetarian and non-had any history of taking Lathyrus sativus (Figure 3). The age of onset of clinical presentation varied from 20-40 years and duration of illness from 1 year to 12 years (Figure 4). Symptoms at the onset were difficulty in walking, stiffness of legs, back pain, weakness of legs, leg pain and urinary discomfort (Table 4) while presenting presentation at our center were disturbed gait, leg stiffness, back pain, leg pain urinary discomfort, urinary retention, tingling and numbness, erectile deficiency in male cases (Table 5). No history of blood transfusion, abortion, delivery or surgery prior to onset of the disease but serum samples revealed

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Tropical spastic para paresis is also common neurological disorder in India though it’s a common in different parts of the world i.e.- including Jamaica, Martinique, Seychelles, Colombia and Japan. Though it was considered as a neurological disorder of obscure etiology but these days it is proved to be caused by Human T cell lymphotropic virus type I (HTLV-I). In spite of advancement in diagnostics like CT, MRI, CSF and Serum for HTLV-I antigen the therapeutics used i.e. alpha interferon, muscles relaxant and neuro vitamin supplement fails to ensure cure or improve quality of life except transient symptomatic relief [18, 19, 20, 21, 22]. Clinical supermacy in term of marked improvement in pain, sensation and gait of the already treated patients with other regime and achieving Grade I clinical response in 88.9% patients and Grade II in rest 11.1%. No patients had any withdrawal or drug adversity in 2 years post therapy follow up. This clinical efficacy can be explained as-Considering its pathogenesis and caused due to HTLV-I infected T cells (Figure 9).

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Self-blood with Betamethasone intramuscular induces antibody formation against the released toxin and ensure their neutralization while betamethasone acting as anti- inflammatory reduces neural edema synergized by Intravenous Calcium administration whose inclusion of one mole exit 2 mole of Sodium acting on Sodium potassium ATPase pump and facilitate decrease in neural edema and calcium ion improves neural conduction. Methyl cobalamine, pyridoxine, Niacin and pantothenic acid support neural cells in its normal neural conduction and Neurovit a herbal composite by its neurogenic activity helps in restoration of neural viability and vitality which combinely ensure relief in pain ,neuropathic manifestation, gait and autonomic function and provide better quality of life to all. Conclusion Present regime constituting Calcium gluconate intravenous, Methyl cobalamine+Pyridoxin+Niacin intravenous, Self blood (2ml) and Betamethasone 2mg intramuscular, cap Cholecalciferol 60K, Syrup Herbal neurotonic (Neurovit) proves worth in management of Tropical spastic para paresis even in chronic and Long term treated cases. References

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