Ayurvedic management of Multiple system atrophy-cerebellar type (~Kampavata): A clinical observation

Abstract: Multiple System Atrophy-Cerebellar subtype (MSA-C) is a rare, rapidly progressive neurodegenerative disorder characterized by cerebellar ataxia, parkinsonism, and autonomic dysfunction, with poor response to dopaminergic therapy. No disease-modifying treatment currently exists in modern medicine. A 65-year-old retired female principal presented with a two-year history of progressive gait difficulty, bradykinesia, generalized rigidity, and hypophonia, with autonomic features including urinary incontinence and orthostatic hypotension, and was wheelchair-bound at the time of initial visit. Notably, neither prior spinal decompression surgery nor anti-Parkinsonian medications had resulted in any improvement. The patient was diagnosed with clinically established MSA-C by Movement Disorder Society criteria and was managed on the lines of Kampavata (~Parkinson’s disease) with Kaphavrita vyana vayu (~ Vyana vayu occluded by Kapha ). Ayurvedic management comprising Mustadi yapana basti, Sarvanga abhyanga (~whole body therapeutic massage), Shashtishali pinda sweda (~sudation therapy with rice boiled in milk and medicated decoction), Shirodhara (~therapeutic oil streaming over the head), and Nasya (~medication through nasal route), alongside oral medications, resulted in marked improvement in gait, balance, and coordination. Marked functional improvement was reported with a decrease in the Unified MSA Rating Scale from 86 to 57 posttreatment. The patient progressed from wheelchair dependence to independent ambulation using a rollator walker. This case highlights the potential of Panchakarma (~five bio-cleansing therapies) based Ayurvedic intervention to modify functional outcomes in MSA-C and warrants further systematic studies.