Ayurvedic management of secondary blepharospasm (Nimesha) by targeting Vyana Vayu Vikriti: A case report

Blepharospasm is a common focal cranial dystonia characterized by involuntary contractions of the orbicularis oculi muscle, resulting in spasmodic closure of the eyelids. The symptoms of blepharospasm are closely related to Nimesha , which is described as Vartmagata Roga by Acharya Sushruta. The present case report highlights the Ayurvedic treatment strategies for the management of blepharospasm. A 36-year-old female presented with blepharospasm, characterized by involuntary bilateral contractions of the eye and facial muscles, and sought Ayurvedic management. She had been experiencing symptoms such as excessive blinking, eyelid twitching, and pain in the facial and jaw muscles for the past 6 months. The treatment plan comprised internal medications like Dashamoola Ksheera Kashaya, Dhanvantaram Kashaya, Kalyanaka Ghrita , and Erandabhrista Haritaki Churna . In addition, external therapies such as facial Abhyanga (massage) with Ksheerabala Taila , Ksheeradhooma (medicated milk vapor), and Shiro Pichu (medicated oil-soaked cotton pad on the scalp) with Ksheerabala Taila were administered. Later, a Mriduvirechana (therapeutic mild purgation) with Nimbaamrutadi Eranda Taila was conducted. The treatment concluded with Shirodhara (medicated oil drip on the forehead) and Netra Picchu (medicated eye pads). After 26 days of treatment, the patient experienced significant relief from pain, with a decrease in the Visual Analog Scale score from 5 to 0. The Jankovic Rating Scale (JRS) for blepharospasm showed a reduction in severity from 4 to 2 and frequency from 3 to 1. The Blepharospasm Disability Index Score (BSDI) showed a significant improvement, decreasing from 10 to 2. This case suggests that Ayurvedic therapies can effectively reduce blepharospasm symptoms and improve the quality of life for patients.