Progressive Supranuclear Palsy (PSP) is a neurodegenerative brain condition , that effect vision , swallowing , thinking ,movement , speech , balance , control of walking , mood and behavior. Important sign of disease is inability to move or aim the eye properly .PSP linked to accumulation of protein called Tau , in this condition Tau forms into clumps which damage nerve cells or nerve endings in brain stem , cerebral cortex areas and basal ganglia .
PSP stands for Progressive meaning gradually getting worse , Supranuclear meaning Above the nuclei of brain (that control movement of eye ) and Palsy meaning Paralysis .
This disease is often misdiagnosed as Parkinson’s or Alzheimer`s diseases due to some of the similar symptoms of the disease . PSP lacks amyloid plaques which are deposits of waxy protein that is common sign in Alzheimer`s disease .
This is kept under the category of Frontotemporal Dementias because it not only displays motor symptoms but also causes some mental impairment .
1 Deterioration of Brain Cell:- The most common cause is gradual deterioration of brain cell . The protein deposit in form of clumps of Tau , they reach to size which can be visible through microscope are called neurofibrillary tangles .
2 Environmental Chemicals :- Certain occupational factors exposing people to different chemicals . Or the people with less education tend to live in areas closer to industrial sites , some of which may generate toxins .
3 Genetic Factor :- It is very rare that the other family member of PSP patient have the same disease .
4 Cellular Damage :- This is caused by free radicals , which are reactive molecules produced by all cells during normal metabolism . Body has built – in mechanism for clearing free radicals from the system , under certain circumstances free radicals can react with and damage other molecules .
1 Poor balance and unsteady gait or walking
2 Cramped Writing and Rigidity or Stiffness .
3 Slowed Movements and soft , slow and slurred speech .
4 Frequent falls generally backwards
5 Blurred eyesight, gaze palsy (the inability to look up or down), slow blinking, difficulty in maintaining eye contact, tunnel vision and sensitivity to light
6 Forgetfulness and Difficulty in swallowing
7 Loss of motivation , Anxiety and Depression
8 Difficulty in finding words (Aphasia ) and Slowing of thought .
9 Personality change that is -loss of interest in ordinary pleasurable activities or increased irritability; difficulty resisting impulses, inappropriate behavior
Initial diagnosis is based on the person`s medical history and physical and neurological exam . which can be on basis of :-
1) Symptoms of disequilibrium, such as difficulty in walking and falls without loss of consciousness.
2) Visual complaints, including blurred vision, difficulties in looking up or down, double vision, light sensitivity, burning eyes, or other eye trouble
3) Slurred speech
4) Various mental complaints e g changes in mood , personality changes, slowness of thought, impaired memory.
5 Diagnostic scans such as magnetic resonance imaging may show shrinkage at the top of the brain stem. Other imaging tests can look at brain activity in known areas of degeneration.
RISK FACTORS :- The only risk factor of the disease is age because it typically affect people around age of 60 .
1 Medication :- Only few medications are available to treat the disease e g :- Levodopa.
2 Therapies :- Professionals such as Occupational Therapist , Speech and Language Therapist , Physiotherapists , special nurses , social workers and Dietician can help the patient of PSP.
3 Muscle Relaxant :- Muscle relaxant and massage can help with cramps .
CAC APRROACH TO THE TREATMENT :-
1 MAKAR RASAYAN TABLET :-
CAC MAKAR RASAYAN tablet is a herbo-mineral tablet and is purely Ayurvedic formulation. CAC MAKAR RASAYAN tablet help in balancing all the three doshas. It helps to rejuvenate body tissues and act as an immuno modulator. It helps in proper blood circulation. It prevents the skin from dryness. It contains natural ingredients like shudha kuchla, guduchi satva, shudha shilajeet, abhrak bhasma, ras sindoor, moonga bhasma, shankh bhasma, praval pishti etc. Herbs and minerals used for the formulation of these tablets show antioxidant, aphrodiasic, analgesic and immuno modulator properties.
2 NERVE UP TABLET :-
CAC Nerve up tablet is a herbo-mineral tablet and is purely ayurvedic formulation. CAC Nerve up tablets help in balancing the vata doshas. It reduces kapha dosha, and acts as nervine stimulant. It shows effective results in improving the central nervous system. It contains natural ingredients like shudha kuchala, shudha shilajeet, abhrak bhasma, praval pishti, shankh bhasma etc. These contains natural vatahar properties and helps in curing vata diseases.
3 PAIN O -KILL TABLET :-
CAC Pain o kill tablet is ayurvedic and purely herbal formulation. It help to relax your muscles and muscles cramps thus relieving pain. It balances all the three doshas of your body thus maintaining proper blood circulation. It provides soothing effect to the affected area of pain. It contains various herbs like Jivanti, Musta, Usher, Bilwa, Shatavri and Kantakari. All these herbs are natural pain relievers.
4 DETOX PREMIUM POWDER :-
CAC DETOX PREMIUM POWDER are herbo-mineral sachets which are purely Ayurvedic formulation. These sachets mainly detox the body and eliminate toxic substances and helps in proper metabolism of all the functions. This formulation act at the level of the nervous system and facilitate proper conduction of signal impulse from the nerves to the muscles. These sachets have anti-inflammatory, antioxidant, and anti-bacterial, anti-fungal, and immune-modulator. The ingredients present in it are moti pishti, parwal pishti, shukta pishti, Giloy satv, kamdudha ras, Jahar Mohra, akik pishti, gandhak rasayan, sutshekhar ras, etc. These ingredients balances all the three doshas (Vata, Pitta & Kapha) and helps in blood purification, reduces burning sensation, weakness, and hot flashes in ulcerative colitis patients. It reduces the level of high uric acid in the body. The powder is very beneficial in relieving discomfort, numbness, muscle ache, and reduces swelling of the pelvic region. This powder provides a cooling & calming effect on the mouth ulcers. It is very beneficial in reducing the swelling, redness, stiffness, and improves the movements of joints.
5 NERVE PLUS TABLET :-
Cac nerve plus tablet contains Ghritkumari, kalimirch, Giloy satva, Shudha shilajeet, Shudha Kuchala, Shudha Vatsnabh etc. These herbs might be beneficial in improving appetite by increasing intestinal motility as well as gastrointestinal functions and also help prevent constipation. It might be good for diabetics due to the presence
of certain constituents that help lower blood glucose levels. Kuchla also helps to manage insomnia by controlling the functions of the brain and reducing stress. It is also beneficial in managing urinary problems like burning sensation or irritation during urination due to its diuretic activity.
According to Ayurveda, the administration of Kuchla is recommended only after its purification (shodhana) in different media like cow’s urine (Gomutra), cow’s milk (Go dugdha) or cow’s ghee (Go ghrita). The final purified product is known as Sudha Kuchla. Sudha Kuchla helps to manage sexual problems like erectile dysfunction due to its Vajikarna (aphrodisiac) property. Kuchla oil can be applied on the joints to provide relief from inflammation and pain associated with rheumatism due to its anti- inflammatory property.
Complications of PSP result primarily from slow and difficult muscle movements which may include:-
1 Falling, which could lead to head injuries, fractures and other injuries
2 Difficulty looking at bright lights
3 Difficulty focusing your eyes, which also can lead to injuries.
4 Problems swallowing, which can lead to choking or inhaling food or liquid into your airway (aspiration)
5 Difficulty in sleeping
6 Pneumonia, which can be caused by aspiration and is the most common cause of death in people with progressive supranuclear palsy.
7 Impulsive behavior that is standing up without waiting for assistance which can lead to falls
Vaidya Karanvir Singh is the younger Vaidya in Chandigarh Ayurved & Panchakarma Centre. He is the fourth generation in his family who is practicing as a general consultant in Ayurved & Panchakarma treatment at Chandigarh. In his practice, he had treated more than 1000 plus patients worldwide.