Ayurvedic Approach Towards Wolf-Hirschhorn Syndrome: A Case Report
Journal name: Ayushdhara
Original article title: Ayurvedic Approach Towards Wolf-Hirschhorn Syndrome: A Case Report
AYUSHDHARA is an international peer-reviewed journal. It focuses on research in Ayurveda, Yoga, Unani, Siddha, Homeopathy, Allopathy, and Pharmaceutical Sciences.
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Anoop A S
Assistant Professor, Department of Kaumarabhrutya (Ayurvedic Pediatrics), Sri Jayendra Saraswathi Ayurveda College & Hospital, Nazrathpet, Chennai, Tamil Nadu, India
A A N Udaykumar
Professor and HOD, Department of Kaumarabhrutya (Ayurvedic Pediatrics), Sri Jayendra Saraswathi Ayurveda College & Hospital, Nazrathpet, Chennai, Tamil Nadu, India
Ayushdhara:
(A peer-reviewed, bi-monthly open-access journal)
Full text available for: Ayurvedic Approach Towards Wolf-Hirschhorn Syndrome: A Case Report
Year: 2023 | Doi: 10.47070/ayushdhara.v10iSuppl2.1187
Copyright (license): CC BY-NC-SA 4.0
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Summary of article contents:
Introduction
Wolf-Hirschhorn Syndrome (WHS) is a rare chromosomal disorder characterized by the partial deletion of the short arm of chromosome 4, also referred to as 4 P syndrome. It presents a range of physical and developmental challenges, with notable features including craniofacial dysmorphism, developmental delays, and seizures. Due to its congenital nature resulting from chromosomal aberrations, WHS can be conceptualized within Ayurveda as a Sahaja Vyadhi (congenital pathology) caused by Beeja dosha (defective germinal elements) that occurs during conception. This case study discusses the application of Ayurvedic principles in managing a patient diagnosed with WHS, focusing on improving developmental outcomes and seizure control.
Ayurvedic Management of Developmental Delay
The case involved a 2-year-9-month-old child exhibiting significant developmental delays across all domains, alongside noticeable dysmorphic facial features. In Ayurvedic terms, the patient's condition was analyzed as Vyadhija Phakka due to observable signs such as weakened bodily vitality and insufficient growth (Pramlaana adhara Kaya, Ksheena mamsa bala). A tailored treatment protocol integrating Phakka chikitsa (management of developmental impairment) and Vataja Apasmara chikitsa (treatment for seizures) was undertaken, emphasizing the correction of developmental milestones. This integrated approach included therapies like Ruksha churna Pinda swedam and systematic medications aimed at enhancing physiological functions and promoting cognitive development.
Addressing Seizures and Associated Symptoms
Another critical aspect of management was the treatment of seizures, classified as Vataja Apasmara in Ayurveda. Seizures were identified as a significant clinical manifestation in the patient, exacerbated by the underlying genetic disorder. To address this, therapies such as Matra Basthi with Kalyanaka Ghritam were employed to counteract Vata disturbances. Additionally, herbal formulations like Smruti Sagara Rasa and various Medhya (cognitive enhancing) remedies were utilized to mitigate seizure frequency and improve mental clarity. The integrated treatment effectively reduced seizure episodes, reinforcing the need for a holistic approach to managing neurological symptoms associated with chromosomal disorders.
Conclusion
In summary, Wolf-Hirschhorn Syndrome represents a complex challenge necessitating a comprehensive management strategy within Ayurveda, framed through the lenses of Sahaja Vyadhi and Vyadhija Phakka. Despite the innate limitations in altering the root genetic causes and associated facial abnormalities, the Ayurvedic treatment protocol provided significant improvements in developmental milestones and seizure management. The case underscores the efficacy of a well-structured Ayurvedic approach in enhancing the quality of life for children with chromosomal conditions, advocating for further exploration of such integrative methods in pediatric care.
FAQ section (important questions/answers):
What is Wolf-Hirschhorn Syndrome and its cause?
Wolf-Hirschhorn Syndrome is a rare chromosomal disorder caused by a partial deletion of the short arm of chromosome 4, leading to various developmental and physical abnormalities in affected individuals.
How is Wolf-Hirschhorn Syndrome understood in Ayurveda?
In Ayurveda, Wolf-Hirschhorn Syndrome is categorized as a 'Sahaja Vyadhi' caused by 'Beeja dosha' during zygote formation, resulting in 'Vyadhija Phakka' with developmental delays and associated features.
What treatment was administered for the patient with Wolf-Hirschhorn Syndrome?
An integrated treatment protocol including 'Phakka chikitsa' and 'Vataja Apasmara chikitsa' focused on correcting developmental delays and preventing seizures, resulting in significant improvements in the child’s milestones.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Ayurvedic Approach Towards Wolf-Hirschhorn Syndrome: A Case Report”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Wolf:
Wolf refers to Kurt Hirschhorn and Herbert L. Cooper who, along with Ulrich Wolf, were the first to report on what is now known as Wolf-Hirschhorn Syndrome. This chromosomal disorder is characterized by the partial deletion of the short arm of chromosome 4, leading to various dysmorphic features.[see source text or glossary: Wolf]
2) Phakka:
Phakka in Ayurveda is a condition characterized by developmental delays and malnourishment. This term is used in the case report to describe symptoms of Wolf-Hirschhorn Syndrome, which include developmental delays and poor physical growth. Ayurveda addresses Phakka through specific treatments to improve development.
3) Brahmi:
Brahmi (Bacopa monnieri) is a herb used in Ayurveda as a Medhya Rasayana, which means it enhances cognitive function. In the case of Wolf-Hirschhorn Syndrome, Brahmi was used topically and internally to support the nervous system and to help manage conditions like seizures and developmental delays.
4) Vyadhin (Vyadhi):
Vyadhi refers to disease or illness in Ayurveda. It’s used to categorize conditions and their treatments. In the document, Wolf-Hirschhorn Syndrome is considered a 'Sahaja Vyadhi,' meaning a congenital disease caused by genetic factors (Beeja dosha) present at the time of conception.
5) Apasmara:
Apasmara is a term in Ayurveda that refers to epilepsy or seizure disorders. In the case of Wolf-Hirschhorn Syndrome, seizures are common, and the treatment protocol included Vataja Apasmara Chikitsa, which is Ayurvedic therapy specifically aimed at managing seizures caused by Vata dosha imbalance.
6) Sahaja (Saha-ja):
Sahaja in Ayurveda denotes conditions that are congenital or present from birth. In the document, Wolf-Hirschhorn Syndrome is described as a Sahaja Vyadhi, meaning it's a congenital disease resulting from genetic mutations, specifically termed as Beeja dosha during the formation of Garbha (zygote).
7) Vataja (Vata-ja):
Vataja refers to conditions caused by an imbalance in the Vata dosha. In the case report, seizures are identified as Vataja Apasmara, suggesting that the seizures are due to Vata imbalance, which is a common feature in patients with Wolf-Hirschhorn Syndrome.
8) Kalyanaka:
Kalyanaka refers to Kalyanaka Ghritam, an Ayurvedic medicated ghee used in the treatment protocols. It aims to balance the Vata dosha and is beneficial for neurological and developmental issues, as seen in treating the developmental delays in Wolf-Hirschhorn Syndrome.
9) Ayurveda (Ayus-veda):
Ayurveda is an ancient system of medicine from India that focuses on maintaining health through a balance of body, mind, and spirit. This system was used in the case report to manage Wolf-Hirschhorn Syndrome, focusing on developmental delays and seizures with traditional treatments.
10) Dosha (Dosa):
Dosha refers to the three fundamental bodily humors in Ayurveda: Vata, Pitta, and Kapha. In the document, Beeja dosha, Vata dosha, and their specific influences on the manifestation of Wolf-Hirschhorn Syndrome (a Sahaja Vyadhi) are discussed extensively, linking genetic issues to Ayurveda.
11) Shiras (Siras, Siro, Shirash):
Shiras refers to the head in Ayurveda. Therapies targeting the Shiras, like Shiro talam and Shiro Pichu with medicated oils, were used to address neurological symptoms and development issues in the patient with Wolf-Hirschhorn Syndrome.
12) Vaca:
Vacha (Acorus calamus) is an herb used in Ayurveda for its cognitive-enhancing properties. Vacha Churnam, a powder form of Vacha, was used in various therapies such as Matra Basti (medicated enema) and oral medications to support neurological functions in the patient with Wolf-Hirschhorn Syndrome.
13) Vata:
Vata is one of the three doshas in Ayurveda, governing movement, circulation, and the nervous system. In the document, Vata imbalance (Vata dosha) is associated with the neurological symptoms and developmental delays seen in Wolf-Hirschhorn Syndrome, guiding the course of treatment protocols.[see source text or glossary: Vata]
14) Ashvagandha (Asvagandha, Ashwagandha, Ashvagamdha, Ashva-gandha):
Ashwagandha (Withania somnifera) is a well-known adaptogenic herb in Ayurveda. It was used in the form of Ashwagandha Churnam (powder) in treatments like Shiro talam to manage stress and support neurological health in the patient suffering from Wolf-Hirschhorn Syndrome.
15) Rasna (Rashna, Rasona, Rasa-una):
Rasna (Pluchea lanceolata) is an Ayurvedic herb used for its anti-inflammatory and pain-relieving properties. In the document, Rasna Churnam was used in combination with other herbs in external applications like Shiro talam to help manage developmental issues and neurological symptoms in the patient.
16) Pinda (Pimda):
Pinda in Ayurveda refers to boluses used in treatments like Pinda Sweda, a type of fomentation therapy. In the case of Wolf-Hirschhorn Syndrome, Ruksha Churna Pinda Sweda with Masha and Kulatha Churnam was administered to address muscle and joint issues associated with developmental delays.
17) Abhyanga (Abhyamga):
Abhyanga is an Ayurvedic therapy involving an oil massage that promotes overall health, balances the doshas, and nourishes tissues. In the treatment of the patient with Wolf-Hirschhorn Syndrome, Sarvanga Abhyanga with Dhanwantaram Tailam was performed to strengthen muscles and improve motor skills.
18) Amalaki:
Amalaki (Emblica officinalis) is a rejuvenating herb in Ayurveda known for its antioxidant properties. In the case report, Amalaki Churnam was used in various treatments such as Shiro talam, aimed at improving cognitive functions and overall health in the patient with Wolf-Hirschhorn Syndrome.
19) Shankara (Sankara, Samkara, Sham-kara):
Sankara in the context of Ayurveda refers to a complex or mixed condition. In the document, Wolf-Hirschhorn Syndrome is understood as a Vyadhi Sankara, meaning a syndrome presenting multiple symptoms or conditions rooted in genetic aberrations (Beeja dosha).
20) Sagara:
[see source text or glossary: Sagara]
21) Ruksha (Ruksa):
Ruksha refers to dryness in Ayurveda, one of the qualities that can aggravate Vata dosha. In the treatment protocol for the patient with Wolf-Hirschhorn Syndrome, Rukshana therapy was initially administered to prepare the body for subsequent nourishing treatments to address developmental delays.
22) Medhya:
Medhya in Ayurveda refers to substances that enhance cognitive function. Herbs like Brahmi and Shankapushpi are Medhya Rasayanas used in the treatment protocol for the patient with Wolf-Hirschhorn Syndrome to improve cognitive development and manage neurological issues.
23) Matra:
Matra refers to a specific measure or quantity. In Ayurveda, Matra Basti is a type of enema with medicated oils or ghee given in a specific quantity. For the patient with Wolf-Hirschhorn Syndrome, Matra Basti with Kalyanaka Ghritam was used to balance the Vata dosha and improve neurological function.
24) Birth:
[see source text or glossary: Birth]
25) Prana (Pran):
Prana in Ayurveda refers to the life force or vital energy that governs breathing and overall vitality. In the context of Wolf-Hirschhorn Syndrome, Prana Vata, one of the subtypes of Vata dosha governing cognitive and neurological functions, is considered in the treatment protocol.
26) Kaya:
Kaya in Ayurveda refers to the body. The treatment protocol for the patient with Wolf-Hirschhorn Syndrome included therapies aimed at strengthening and nourishing the Kaya, such as Sarvanga Abhyanga and Pinda Sweda, to improve physical health and address developmental delays.
27) Rasa (Rasha):
Rasa in Ayurveda refers to taste (one of the five elements) and also to a preparation form. Smruti Sagara Rasa is an Ayurvedic formulation used in the document to manage seizures in the patient with Wolf-Hirschhorn Syndrome, exploiting its cognitive-enhancing and neuroprotective properties.
28) Bala:
Bala in Ayurveda refers to strength or capacity. In the treatment of the patient with Wolf-Hirschhorn Syndrome, Bala was improved through therapies aimed at enhancing physical strength and cognitive functions, such as Abhyanga and the administration of Medhya Rasayana herbs.
29) Shashtikashali (Sastikasali, Shashtika-shali):
Shashtika Shali in Ayurveda refers to a specific type of rice used in Pinda Swedam for its nourishing properties. In the case report, Shashtika Shali Pinda Swedam was used to strengthen muscles and improve tone in the patient with Wolf-Hirschhorn Syndrome, aiding in developmental milestones.
30) Pranavata (Prana-vata):
Prana Vata is a subtype of Vata dosha that governs cognitive and neurological functions. In the document, therapies aimed at balancing Prana Vata were integral in treating developmental delays and preventing seizures in the patient with Wolf-Hirschhorn Syndrome.
31) Samshushka (Samsuska):
Samshushka describes dried or emaciated physical state in Ayurveda. It is one of the symptoms seen in Vyadhija Phakka or malnourishment, as observed in the patient with Wolf-Hirschhorn Syndrome where signs like dry and thin body, especially in the facial region, were present.
32) Rudraksha (Rudraksa, Rudra-aksha):
Rudraksha Churnam was part of the oral medication regimen used for the patient in the case report. Rudraksha is traditionally known for its auspicious properties and can be part of formulations aimed at improving cognitive functions and managing stress in Ayurvedic medicine.
33) Shashtika (Sastika):
Shashtika refers to a type of therapeutic rice used in Ayurveda, especially in Pinda Swedam. This therapy was applied to the patient with Wolf-Hirschhorn Syndrome to nourish and strengthen the body, thereby helping to achieve delayed motor milestones.
34) Rajanyadi:
Rajanyadi Churnam is an Ayurvedic herbal powder used in the treatment protocol. It was combined with other churnas like Vacha and Rudraksha to support cognitive and physical development in the patient with Wolf-Hirschhorn Syndrome.[see source text or glossary: Rajanyadi]
35) Rukshana (Ruksana):
Rukshana is a preparatory treatment in Ayurveda that involves the use of dry therapies to balance the doshas. In the document, Mrudu Rukshana was part of the initial treatment for the patient with Wolf-Hirschhorn Syndrome to prepare the body for subsequent nourishing therapies.
36) Lakshana (Laksana):
Lakshana in Ayurveda refers to the symptoms or signs of a disease. In the document, various Lakshanas of Vyadhija Phakka, such as Pramlaana adhara Kaya and Ksheena mamsa bala, were observed and addressed in the treatment protocol for the patient with Wolf-Hirschhorn Syndrome.
37) Language:
[see source text or glossary: Language]
38) Avaleha:
Avaleha refers to a semi-solid Ayurvedic formulation. Kalyana Avaleha Churnam was included in the oral medications for the patient with Wolf-Hirschhorn Syndrome to support overall well-being and cognitive functions, aiding in the management of developmental delays.
39) Kulatha:
Kulatha (horse gram) is an Ayurvedic herb used in dry fomentation therapies. Kulatha Churnam was part of Ruksha Churna Pinda Sweda, aimed at balancing Vata dosha and preparing the body for nourishing treatments in the patient with Wolf-Hirschhorn Syndrome.
40) Kalyana:
Kalyana in the document refers to Kalyanaka Ghritam, a medicated ghee used for its Vata-balancing properties. It was administered in various forms like Matra Basti to improve cognitive functions and speech in the patient with Wolf-Hirschhorn Syndrome.
41) Chennai:
Chennai is the location of Sri Jayendra Saraswathi Ayurveda College & Hospital, where the patient with Wolf-Hirschhorn Syndrome was treated. This geographical detail helps understand the context and setting of the Ayurvedic treatment protocol administered.
42) Disease:
[see source text or glossary: Disease]
43) Dravya:
Dravya in Ayurveda refers to substances or materials used in treatments. Various Dravyas like Brahmi, Ashwagandha, and Dhanwantaram Tailam were used in the treatment protocol for the patient with Wolf-Hirschhorn Syndrome to manage symptoms like developmental delays and seizures.
44) Garbha:
Garbha refers to the embryo or fetus. In the document, Wolf-Hirschhorn Syndrome is described as a Sahaja Vyadhi caused due to Beeja dosha, which occurs during the formation of Garbha (zygote), leading to congenital conditions and genetic aberrations.
45) Gutika:
Gutika refers to pill formulations in Ayurveda. Dhanwantaram Gutika was one of the internal medications given to the patient with Wolf-Hirschhorn Syndrome to support overall health and manage symptoms like developmental delays and neurological issues.
46) Adhara:
Adhara indicates the support or base. In the context of Vyadhija Phakka, symptoms like Pramlaana adhara Kaya (weak and thin body) were noted. Treatments aimed at supporting and nourishing the body (Adhara) were included in the protocol for the patient with Wolf-Hirschhorn Syndrome.
47) Mukha:
Mukha in Ayurveda refers to the face or mouth. In the document, the term Samshushka shiro mukha points to signs of malnourishment and developmental delays observed in the patient with Wolf-Hirschhorn Syndrome, specifically dryness and thinness in the facial region.
48) Udana:
Udana refers to one of the subtypes of Vata dosha governing speech and respiratory functions. In the case report, therapies aimed at balancing Udana Vata were used to improve language and communication milestones in the patient with Wolf-Hirschhorn Syndrome.
49) Mamsa (Mamsha):
[see source text or glossary: Mamsa]
50) Sira (Shira):
Shira is another term for the head in Ayurveda. Treatments like Shiro Pichu and Murdhni Tailam were used on the Shira to manage the neurological symptoms of the patient with Wolf-Hirschhorn Syndrome, aiming to improve cognitive functions and developmental delays.
51) Shali (Sali):
[see source text or glossary: Shali]
52) Masha (Masa, Ma-sha):
Masha (black gram) is a commonly used herb in Ayurveda for its nourishing properties. Masha Churnam was used in combination with other herbs in Ruksha Churna Pinda Sweda to help manage muscle and joint issues related to developmental delays in the patient with Wolf-Hirschhorn Syndrome.
53) Picu:
Pichu refers to a form of Ayurvedic treatment where a cloth is soaked in medicated oil and applied to the body. Shiro Pichu with Dhanwantaram and Brahmi Tailam was used on the patient with Wolf-Hirschhorn Syndrome to support neurological health and cognitive functions.
54) Roga:
Roga in Ayurveda refers to disease or illness. In the document, Vyadhija Phakka Roga is mentioned as a condition with symptoms like malnourishment and developmental delay, which were observed in the patient with Wolf-Hirschhorn Syndrome and addressed through specific Ayurvedic treatments.
55) Guna:
Guna in Ayurveda refers to qualities or attributes of substances and doshas. In the document, concepts like Ruksha guna (dry quality) and Sthira guna (stable quality) are discussed in the context of treatments for balancing doshas in the patient with Wolf-Hirschhorn Syndrome.
56) Food:
[see source text or glossary: Food]
57) Udanavata (Udana-vata):
Udana Vata is a subtype of Vata dosha responsible for speech, respiration, and cognitive functions. The treatment protocol included therapies aimed at balancing Udana Vata to improve speech and development in the patient with Wolf-Hirschhorn Syndrome.[see source text or glossary: Udana-vata]
58) Vatadosha (Vatadosa, Vata-dosha):
Vata Dosha is one of the three fundamental bodily humors in Ayurveda. In the case report, the management of Vata dosha was crucial because its imbalance was linked to neurological issues and developmental delays in the patient with Wolf-Hirschhorn Syndrome.
59) Discussion:
The discussion section in the document elaborates on how Wolf-Hirschhorn Syndrome was managed through Ayurvedic treatments. It explains the rationale for the integrated treatment approach, focusing on correcting developmental delays and preventing seizures by balancing doshas.
60) Tamilnadu (Tamil-nadu):
Tamil Nadu is the state in India where Sri Jayendra Saraswathi Ayurveda College & Hospital is located, where the patient with Wolf-Hirschhorn Syndrome was treated. This detail provides context about the healthcare setting and regional practices in Ayurveda.
61) Rasayana (Rasa-ayana):
Rasayana in Ayurveda refers to rejuvenation therapies that enhance overall health and longevity. In treating the patient with Wolf-Hirschhorn Syndrome, Medhya Rasayanas like Brahmi and Shankapushpi were used to improve cognitive functions and manage developmental delays.
62) Medicine:
Medicine in the context of the document pertains to various Ayurvedic formulations and treatments used to manage Wolf-Hirschhorn Syndrome. These included oral medications, external therapies, and specific regimens to address developmental delays and seizures.
63) Bhavana (Bha-vana):
Bhavana refers to the process of triturating Ayurvedic medicines with specific herbs or juices. Smruti Sagara Rasa, used in the treatment of the patient with Wolf-Hirschhorn Syndrome, involves Bhavana with Vacha Swarasa and Brahmi Swarasa to enhance its efficacy in managing cognitive functions and seizures.
64) Prakopa:
Prakopa in Ayurveda refers to the aggravation of doshas. In the case report, managing Vata Prakopa was essential in treating symptoms like seizures and developmental delays in the patient with Wolf-Hirschhorn Syndrome, guiding the choice of therapies and medications.
65) Sthira:
Sthira refers to stability or steadiness, a quality attributed to Kapha dosha. In the document, the thinning of the Corpus Callosum is considered a reduction in Sthira guna due to Vata imbalance, prompting treatments aimed at restoring stability through nourishment.
66) Nidana:
Nidana in Ayurveda refers to the causative factors of a disease. The document mentions Pyogenic Meningitis as a Nidana for Vyadhija Phakka in the patient with Wolf-Hirschhorn Syndrome, contributing to developmental delays and informing the treatment approach.
67) Family:
[see source text or glossary: Family]
Other Science Concepts:
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