Peripheral sensory loss and Thermanaesthesia

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                                 Dr.Bhat.A.Rangaprasad -Sarve janah Sukhino Bhavanthu || Sarve santhu Niramayah ||

Mr.Mohan aged 55 years, approached and consulted at S.P.K.V.C.C, in the month of December 2009,inquiring about the possibility of getting relieved from his current problem of peripheral sensory loss in the form of analgesia and thermanesthesia at the region of left flank and left lower limbs associated with weakness of right upper & lower extremities.He was presenting with mild kyphosis at the level of T-12 - L-1 too.
The above case is being described henceforth.

History of present illness :

In march 1999, when at New Delhi, he developed Right Hemiplegia due to T.I.A ( Transient Ischemic Attack). Three days later, developed Peritonitis due to Perforated Duodenal Ulcer for which surgical intervention in the form of Peritoneal lavage was done.In January 2003, he was diagnosed & operated for C5 - C6 subluxation.

History of present illness :

* Weakness of right lower limb.

* Numbness of left hypothenar eminence in associated with thermanaesthesia.


* Weakness of right little & ring fingers.

* Total thermanaesthesia & loss of sensations of touch; pressure;& pain, in the flank, portions of lower abdomen, groin, lateral aspect of thigh, dorsal aspect of foreleg, dorsal aspect of foot etc., on the left side.

*Half circumduction and high stepped gait.

*Lower limb length discrepancy noted with right leg shorter by 10 m.m than the left leg.

*Pain & tenderness in the region of T12-L1.

*On examination, the T12 spine was found to protrude out with 2+ tenderness associated with stiff right para-vertebral muscle.Mild kyphosis too was observed (T12 over riding L1 due to Thoracic spondylolisthesis).

Treatment Modules selected :

* Marma chikitsa manipulating the vertebral column; Nabhi; Lohitaksha; Urvi; Ani; Indrabasti; Gulpha; Talahrdaya; Kshipra; Parshva & Brhati were done.

* Susumna vasti @ the regions of T12-L1 & L4-L5-S1.

* Masha pinda svedam were done for 20 days in 2 different sessions of 10 days each with a gap of 1 month in between.

Improvement observed in the patient during the course of treatment :

# On completing the 3rd sitting Mr.Mohan got relieved of the stiffness @ back & left lower limb.

# After 6th sitting, sensation of pain and pressure at the affected areas started regaining slowly.

# The otherwise protruded vertebral spine at the regions of T12 - L1 got depressed and became even with that of the other adjacent spines, on completion of 8th sitting.

# 10th day he started regaining the touch sensation to a little extent. And his gait improved from half circumduction to almost normal, but with little limping (due to length discrepancy of legs).

After a gap of one month, the patient maintained a good sign of improvement with regards to peripheral sensation in terms of touch,pressure and pain.but, the thermanaesthesia remained the same.


# The next 10 days of sitting were fruitful with regards to the improvement in regaining the peripheral sensation in terms of touch,pressure and pain. But, with regards to the perception of heat or temperature, there was quite an amount of fluctuation. In the sense, Mr. Mohan was able to perceive the heat at some times and not so definitive at other occasions of the 2nd session of the traetment scheduled.

Conclusion :

The patient felt happy in getting relieved of almost 80% of the symptoms,in post treatment period.The only suffering of total thermanaesthseia remains to be a bitter one in the mind of both patient and myself.for further strengthening of the nerve in enhancing it's conduction internal medicines prepared with herbals like Withania somnifera, Mucuna pruriens, Apium graveolens etc. and others have been prescribed.