Management of Tolosa-Hunt syndrome with Ayurveda therapeutic measures and interventions: A case report

Abstract

BACKGROUND: Tolosa-Hunt syndrome (THS) is a rare disorder characterized by episodic periorbital pain associated with paralysis of either one or more of the III, IV, or VI cranial nerves. It is usually self-resolving, but relapse may be seen. In Ayurveda, a clinical condition “Vatahata Vartma” is narrated, resembling THS. Based on the resemblance, a diagnosed case of THS was treated by Ayurveda measures and treatment described for the management of Vatahata Vartma.MATERIALS AND METHODS: A 50-year-old man, who was previously diagnosed and underwent treatment for THS, presented with complaints of increased drooping and swelling at his left upper eyelid along with strenuous eyeball movements since February 2021. Drooping of the eyelids was measured by the amount of ptosis, margin-reflex distance, and the function of the levator palpebrae superioris. The patient was treated with Ayurveda oral medicines (herbal decoctions, herbal clarified butter, herbal powders, and herbal tablets), biopurification (therapeutic purgation and retention of medicine in the buccal cavity), and external Ayurveda ocular therapy (ocular irrigation, bolus sudation, eye drops, herbal paste over the eyelids, retention of herbal clarified butter over the eyes, collyrium, paste over the head, and irrigation over the head). The total duration of therapy was 11 months. RESULTS: Swelling and ptosis of the left upper eyelid were reduced, and the patient could do the normal movement of the left upper eyelid. CONCLUSION: THS can be treated with Ayurveda measures and interventions narrated in Ayurveda under Vatahata Vartma. A clinical study on large sample size is required to validate the result obtained in the present case study.