Emergency Home-Based Ayurvedic Intervention (Sadyo Snehana and Nasya) During a Transient Ischaemic Attack in a Remote, Resource-Limited Setting: A Case Report

Abstract

Background: Transient ischaemic attack (TIA) is a medical emergency. It is also a warning sign of impending stroke. The risk is higher in patients with serious comorbidities. In remote, resource-limited settings, emergency neurological care is often not available in time. Safe initial measures therefore deserve documentation. Case presentation: A 58-year-old female developed sudden left hemiparesis at her remote home. She had post-CABG triple-vessel disease, insulin-dependent diabetes mellitus, hypertension and chronic kidney disease (CKD). The weakness was accompanied by Stambha (limb stiffness) and a transient decline in consciousness. Capillary blood glucose at onset was 124 mg/dL, which excluded hypoglycaemia. Intervention: No emergency facility was available nearby. The attending Ayurvedic physician administered Sadyo Snehana (acute oral oleation) with groundnut oil. This was followed by Nasya (nasal administration) with Mahanarayana Taila. Both were given during the symptomatic window. Outcomes: The stiffness resolved rapidly. Blood pressure fell from 160/90 to 130/84 mmHg. Full responsiveness returned within an hour. The next day, a neurologist and MRI (no acute infarct) confirmed the diagnosis as TIA. Complete functional recovery (Modified Rankin Scale 0) was reached by Day 35. Serum creatinine improved from 1.7 to 1.4 mg/dL. There was no recurrence at three months. Conclusion: This report records the feasibility and safety of a home-based Ayurvedic intervention during a TIA in a resource-limited setting. A TIA resolves on its own. Therefore a causal effect on recovery cannot be inferred from a single case. The observations are hypothesis-generating. They warrant systematic prospective study.