Ayurvedic management of limb girdle muscular dystrophy in a twelve-year-old patient with Panchakarma and Shamana Chikitsa: a case study

Background

Limb girdle muscular dystrophy is a genetically heterogeneous group of progressive muscle disorders for which no curative treatment exists, and care is largely supportive. In Ayurveda the presentation can be understood as Mamsa dhatu kshaya with Vata vitiation. Aim and objectives: To document the Ayurvedic management of one child with limb girdle muscular dystrophy and to describe the clinical and biochemical course during hospital care. Observations: A twelve-year-old girl presented with difficulty in rising from sitting, inability to climb stairs, frequent falls while running, a waddling gait and a positive Gowers sign. Serum creatine phosphokinase was 3528.1 at baseline, with raised liver transaminases and a low vitamin D level. Neurology and rheumatology opinions and echocardiography were obtained, and blood was sent for genome sequencing. She was admitted for 53 days and received Abhyanga with Mahanarayana taila and Mahamasha taila, Shashtikashali pinda sweda, and Basti with Bala taila, Mustadi yapana basti and Sanvardhana ghrita, together with oral Shamana formulations and nutritional supplements. Main findings: Creatine phosphokinase measured 1429, 1123 and 1308 on repeat testing, a fall of about 63 percent from baseline at the last measurement. She was haemodynamically stable at discharge and no adverse event was recorded. Functional outcome was not quantified and the genetic diagnosis was awaited.