MOTOR NEURONE DISEASE (MND) is the name given to a group of related diseases affecting the motor neurones in the brain and spinal cord. Motor neurones are those nerve cells that control muscles, and their degeneration leads to weakness and wasting of muscles, causing increasing loss of mobility in the limbs, and difficulties with speech, swallowing and breathing.
Progress is relentless and generally rapid, with a life expectancy of between two and five years from the onset of symptoms. Approximately 20% of patients can survive for 5-10 years but the rate of progression varies greatly from one person to another. Death usually occurs due to respiratory failure.
The incidence of MND is 2 per 100,000 of total population, while prevalence is six per 100,000 of total population. Research has found that the incidence is higher in people aged over 50 years. Only 10% of cases are familial (inherited) with the remaining 90% sporadic. The male to female ratio is 2:1.
SYMPTOMS OF MOTOR NEURONE DISEASE
The symptoms of motor neurone disease usually follow a pattern that falls into three stages:
- the initial stage
- the advanced stage
- the end stage
There are different types of MND, each affecting people in different ways.
This is of course a diagnosis which needs a great deal of careful consideration given the poor prognosis. Nevertheless, it is equally important to ensure that the diagnosis is not unduly delayed. One study found that the average time from suspected diagnosis to confirmation was one year.
Diagnosis should be made after consideration of the clinical signs and symptoms together with investigations to exclude other causes.
Because of the very variable clinical presentation, the diagnostic criteria below have been devised, taking into account investigations to confirm the diagnosis and refute other possible causes (revised El Escorial Criteria):
- Evidence of LMN degeneration by clinical, electrophysiological or neuropathological examination.
- Evidence of UMN degeneration by clinical examination.
- Progressive spread of symptoms or signs within a region or to other regions, as determined by history or examination
Together with the absence of:
- Electrophysiological and pathological evidence of other disease processes that might explain the signs of LMN and/or UMN degeneration.
- Neuroimaging evidence of other disease processes that might explain the observed clinical and electrophysiological signs.
Ayurveda Perspective & Management of MND/ALS
In Ayurveda, health is defined as the state where physical body, senses, and psyche are in original or natural state with respect to body and function.
Although there is no precise equivalent for MND in Ayurveda, MND can be considered as ‘VATA’ predominant disease. Vata is considered as a chief factor for the physiological maintenance of the body. Vata biofactor is responsible for functions of the central, autonomic, and peripheral nervous systems. Vata controls the respiratory, blood, lymphatic, excretory, and reproductive systems, as well as all types of movements. It is also responsible for the cognitive and neocognitive function of the brain and secretion of various chemical neurotransmitters and hormones. This description of Vata resembles the functions of central, peripheral, and autonomic nervous systems.
The Vata diseases as described in Ayurvedic classics include a wide range of neurological morbidities, including inflammatory, degenerative, obstructive, and functional. Factors provoking Vata result in the instantaneous manifestation of diseases, which can even prove to be fatal.
Most of the signs & symptoms of MND like fasciculations, cramps, wasting, weakness, spasticity, bulbar symptom etc. match that of the classical signs & symptoms of Vata derangement described in Ayurveda. So the line of treatment in Ayurveda mainly focuses on the pacification Vata and bringing back the equilibrium between all the three Doshas (Vata, Pitta & Kapha).
‘CHARAKA-THE SPECIALITY AYURVEDA’ Institute of Panchakarma & Research, a traditional health care center, started treating MND/ALS cases since the year 2003. Our knowledge of MND has evolved greatly over the past few years. We have been continuously working on this disease and are committed for the better success in treating MND patients.
CHARAKA Ayurveda facility offers a very effective treatment methodology for MND, based on the classical texts of Ayurveda. Management of MND is usually aggressive and primarily consists of four procedures:
- samsodhan (cleansing through Panchakarma therapy)
- samsaman (palliative care through researched internal medicines)
- kaya kalp (rejuvenation)
- sattvavajaya (counseling/psychotherapy)
Along with these, strict diet & life style modification will be advocated.
Ayurveda therapy can be comfortably combined with Riluzole therapy as there is no interaction between Ayurveda medicines & Riluzole.
Today, CHARAKA stands to be the most experienced Ayurveda facility in India for treating MND cases. Apart from treating, we are also educating and creating awareness among the MND patients and their relatives.
Inspite of the best possible treatment efforts, currently complete cure of MND in most of the cases is not possible as this disease as per Ayurveda comes under the criteria of ‘Kashta saadhya roga’ (difficult to cure).
***IMPORTANT ISSUE TO BE NOTED AND UNDERSTOOD BY ALL MND PATIENTS AND THEIR ATTENDENTS***
EARLY DIAGNOSED & TREATED CASES RESPOND TO THE MAXIMUM AND RATE OF SUCCESS WILL DECREASE WITH CHRONICITY OF THE DISEASE.