A sudden, reduced blood supply to the brain causes mild or extensive brain damage, leading to a medical condition known as hypoxic ischemic encephalopathy. This condition is also known as global hypoxic-ischemic injury or cerebral hypoxia, in older children and adults. The condition may occur in neonates before the onset of labor, during the actual delivery, or after delivery. Extensive brain damage in neonates may cause abnormal levels of consciousness, muscular tone, reflexes, feeding and respiration; as well as convulsions. The presentation of symptoms is different according to the age group affected. Drowning and asphyxiation are common causes of cerebral hypoxia in older children. In adults, cardiac arrest or cardiovascular diseases cause brain damage due to secondary hypoxia.
This condition can be classified – depending upon the severity — as diffuse, focal, global, and massive. The reduction or cessation of oxygen to the brain causes death of the brain cells within a few minutes. Depending upon the severity, symptoms can be temporary, long-term or permanent, leading to motor and sensory disability, paralysis, and even death. The management of this condition in the modern system of medicine is mainly supportive, and depends upon neurological disability and organ dysfunction. Conservative management includes supply of oxygen, inducing hypothermia (in neonates), removing the known causes, and giving supportive intensive care treatment.
Irrespective of age and projected severity, hypoxic ischemic encephalopathy needs to be treated on an emergency footing, and calls for immediate intensive care in order to prevent long-term disability and permanent brain damage, as well as saving life. This treatment is highly specialized and can only be done in modern hospitals with advanced intensive care facilities. Long-term management includes regular assessment, physiotherapy, and occupational therapy.
Ayurvedic treatment can be utilised in the management of hypoxic ischemic encephalopathy, once the critical stage has passed, and there is a need to assess and treat long-term disability, complications and organ damage. The overall treatment needs to be decided after a complete assessment of the residual damage and disability. Ayurvedic herbal medicines which have a specific action on the central nervous system and the brain cells form the mainstay of treatment in the management of this condition. These medicines need to be given for prolonged periods and in high doses in order to strengthen the nerve cells in the brain as well as the central nervous system, and reduce or reverse brain damage to the maximum extent possible. This treatment can also bring about improvement at the neuromuscular junction levels and improve muscle strength, tone and coordination.
In addition, herbal medicines which can be utilised to treat cardiovascular disease and inflammation, and reduce blockage in arteries and capillaries, are also very useful in the management of this condition. Oral treatment can be supplemented with localised therapy in the form of generalised massage using medicated oils and pastes, followed by steam fomentation using medicated decoctions. Special procedures like Shiro-dhara and Shiro-basti are also very useful in the management of the long-term disability resulting from hypoxic ischemic encephalopathy.
The duration of Ayurvedic herbal treatment depends upon the severity of the symptoms, and the extent of damage which can be controlled, treated, or reversed. Treatment is required for periods ranging from 6 to 15 months. The main aim of Ayurvedic herbal treatment is to improve quality of life, reduce disability, prevent or reduce long-term complications, and improve overall survival. Ayurvedic herbal treatment thus has a definite role to play in the long-term management and treatment of hypoxic ischemic encephalopathy.