Neuromyelitis optica is a medical condition related to the eyes and is also known as NMO or Devic’s disease. This condition involves a concurrent inflammation and demyelination of the optic nerve as well as the spinal cord. This ultimately causes varying degrees of blindness, as well as symptoms of the lower extremities which include weakness and paralysis of the legs, and bladder as well as bowel dysfunction. This is an auto-immune condition, but is different from multiple sclerosis. NMO may be associated with other systemic diseases, and is diagnosed by the presence of antibodies in the blood. Acute attacks rapidly bring about disability, which can be treated satisfactorily with intravenous steroids, plasmapheresis, and immuno-suppressant drugs. However, this condition displays a tendency for relapse and there is no long-term cure.
Being an auto-immune disorder, the mainstay of Ayurvedic herbal treatment is to provide immunomodulation to affected individuals so as to reverse the main pathology of the disease. In addition, symptomatic treatment needs to be given for all the presenting symptoms in affected individuals. Ayurvedic herbal medicines which have a specific affinity for the optic nerve and retina are used in high doses for prolonged periods. In addition – depending upon the presentation of symptoms – different herbal medicines are used to treat weakness and paralysis of the lower limbs as well as involvement of the bladder and bowels.
Medicines which have an anti-inflammatory action are useful in the treatment of this condition so as to prevent further damage to the affected nerves. Herbal medicines which have a direct action on the central nervous system and which bring about a gradual reversal of demyelination, and repair of nerves are used successfully in the management of NMO. These medicines include Saptamrut Loh, Panchtikta Ghrut, Triphala Ghrut, Triphala Guggulu, Punarnava Mandur, Punarnava Guggulu, Trayodashang Guggulu, Sameerpannag Ras, Maha Vat Vidhvans Ras, Bruhat Vat Chintamani Ras, Manjishthadi Qadha, Saarivadi Vati, Pathyadi Qadha, Saraswatarishta, Brahmi Vati and Vasant Kusumakar Ras.
Herbal medicines which have a specific action on damaged nerves include Ashwagandha (Withania somnifera), Shatavari (Asparagus racemosus), Bala (Sida cordifolia), Brahmi (Bacopa monnieri), Shankapushpi (Convolvulus pluricaulis), Vacha (Acorus calamus), Jatamansi (Nardostachys jatamansi), Haridra (Curcuma longa), and Yashtimadhuk (Glycyrrhiza glabra). Herbal medicines which have an anti-inflammatory action include Guggulu (Commiphora mukul), Punarnava (Boerhaavia diffusa), Triphala (Three fruits), Shallaki (Boswellia serrata), Lashun (Allium sativum), Sunthi (Zinziber officinale), Manjishtha (Rubia cordifolia), and Saariva (Hemidesmus indicus).
Medicines which bring about immunomodulation in affected individuals include herbal medicines like Kutki (Picrorrhiza kurroa), Ashwagandha (Withania somnifera), Shatavari (Asparagus racemosus), Tulsi (Ocimum sanctum), Bhrungraj (Eclipta alba), Pippali (Piper longum), Bhumiamalaki (Phyllanthus niruri), Chitrak (Plumbago zeylanica), Patol (Tricosanthe dioica), Patha (Cissampelos pareira), Nimba (Azadirachta indica), Musta (Cyperus rotundus), Guduchi (Tinospora cordifolia) and Amalaki (Emblica officinalis).
Oral treatment in the form of herbal tablets can also be supplemented with the use of herbal eye drops as well as application of medicated oils and ointments on the back and lower extremities. Ayurvedic herbal treatment is usually required for periods ranging from 12-18 months, depending upon the severity of the condition. The aim of Ayurvedic treatment is to treat symptoms, prevent further degeneration of vision and lower limb disability, and bring about recovery to the maximum extent possible. Ayurvedic herbal treatment thus has a definite and positive role in the treatment and management of neuromyelitis optica.