This document discusses Ardita Vata (facial palsy) according to Ayurveda and modern medicine. It defines Ardita Vata as a deviation leading to deformity of one side of the face or half of the body. The causes, symptoms and types are described according to Ayurvedic texts like Charaka Samhita. Bell's palsy, the most common type of facial palsy, is also discussed in detail including causes like infection, trauma and tumors. The document compares unilateral lower motor neuron lesions in Bell's palsy versus bilateral upper motor neuron lesions. Various treatment approaches are summarized including nerve grafts, slings and weights to correct facial paralysis.

1. By N. Jagadish

2. INDEX:
 Definition-Ardita vata
 Introduction
 Nidanam
 Samprapti
 Poorva rupa
 Rupa
 Types
 Treatment

3. DEFINITION:
 It is a disease in which there is a
deviation leading to deformity of one
side of face alone or along with half side
of the body.

4. INTRODUCTION:
 Acc to Charaka & Vagbhata ardita vata
is included in the group of Vataja
Nanatmaja Vyadhis.
 Acc to Charaka he also included the
same ardita vata under Samanya siro
rogas.

5. NIDANA:
 Carrying heavy weights on head
 Excessive yawning,laughing
 Pregnant woman
 Shouting loudly
 Eating hard foods
 Old persons
 Children
 Fear
 Grief

6. SAMPRAPTI:
Vata gets aggravated
Localised in
head,nose,lips,chin,forehead,eyes
Causes sankocha of organs&produces
pain and causes ardita vata.

7. POORVA RUPA:
 Horripulations
 Tremors
 Belching
 Loss of sensation&pain in skin
 Catching pain in shoulders

8. RUPA:
 Absence of nasolabial fold on affected
side
 Absence of wrinkles on head
 Drooping of eyelid
 Deviation of mouth to healthy side
 Difficult in chewing
 Slurred speech
 Tremors of neck

9. TYPES:
 According to vagbhata 2 types
Ardita
vata
Ardita Ekayama

10.  According to charaka 2 types
Ardita vata
Ardita
Visista
ardanga
vata

11.  According to bhavamisra and
yogaratnakara 3 types based on dosas
 1)vata ardita -pain,excessive
salivation,oedema of lips.
 2)pitta ardita - trsna,jwara,daha.
 3)kapha ardita - oedema in
neck&stiffness.

12. ASADYA LAKSHANAS:
 According to susruta
1)ksheena-weak person
2)Inability to close eyes
3)Disturbed or slurred speech
4)Excessive nasal secretions
5)Excesive tear drops
6)excessive oral secretions

13. TREATMENT:
 According to charaka& Susrutha.
 1)nasya - shadbindu taila or anutaila
 2)nadi swedana
 3)upanaha - meat of animals of marshy
lands(anoopa prani)
 4)moordha taila - application of oil on head
as
• Pichu
• Sirovasti
• Sirodhara with ksheera bala or
nirgundi taila

14.  According to vagbhata
- 1)nasya
- 2)karna poorana
- 3)akshi tarpana
- 4)emesis
- 5)venesection
 According to bhavamishra
Ksheera prepared with DMQ or
BMQ

15. FACIAL
PALSY

16. DEFINITION:
 Paralysis of any structures innervated by
facial nerve is known as facial palsy.
Facial
paralysis
Supra nuclear
lesions
Caused due to
lacunar infarct
affecting fibres
in internal
capsule
Infra nuclear
lesions
Majority of
causes of facial
palsy is due to
this lesions

17. SUPRA NUCLEAR &INFRA
NUCLEAR LESIONS:
 The facial motor
nucleus have two
divisions.
1)dorsal division
2)ventral division
 Dorsal division
contains UMN’S
which recieves
bilateral input from
brain.
 Ventral division
contains LMN’S which
receives only contra
lateral input.

18. FACIAL NERVE AND ITS
SUPPLY TO THE MUSCLES:

19. BRANCHES OF FACIAL
NERVE:
 Temporal branch –
supplies to frontalis
&orbicularis oculi.
 Zygomatic branch –
supplies to orbicularis
oculi.
 Buccal branch –
supplies to upper lip
&cheek.
 Mandibular branch –
supplies to lower lip.
 Cervical branch –
supplies to neck
muscles.

20. SYMPTOMS:
 Unilateral facial weakness.
 Loss of taste.
 Hyperacusis-A heightened sensitivity to
some sounds.
 Decreased salivation & tear secretion.

21. TYPES OF FACIAL PALSY:
 Different types of facial palsy according to
the point at which the nerve is affected.
1)lesion in pons - taste&hearing not effected
2)Lesion in petrous bone – palsy of facial
muscles+loss of taste
3)Lesion in chorda tympani – no salivary
secretions
4)Lesion in stonpedius – sense of hearing is
loss

22. Difference between UMN&LMN
Lesions
UMN LESIONS LMN LESIONS
Only lower 2/3 rd of the
facial muscles are
affected.
Mid face is paralysed.
Eye brow’s can move
normally.
Totally half side of the is
affected.
Half of the Mid face is
only paralysed.
Eye brow’s can’t move
normally.

23. BELL’S PALSY:
 It is the commonest type of facial palsy.
 It is the major cause of the acute facial
nerve paralysis.
 It affects totally half side of the face due to
the LMN Lesion.
 Here the palsy is due to the inflammation of
the facial nerve.
 The inflammation prevents nerve from
sending correct signals to brain &facial
muscles.

24. SYMPTOMS:

25. CAUSES:
 Infection
 Trauma
 Tumour
 Other causes

26. INFECTION:
 Herpes zoster virus - reactivation of virus
within dorsal root ganglion of facial nerve
is assosiated with vesicles affecting ear
canal.
 Symptoms -1)ear pain
2)vesicles
3)hearing loss
4)vertigo
o Treatment –1)anti viral
2)steroids(corticosteroids)

27.  Otitis media –inflammation of the middle
ear due to infections can spread to facial
nerve &inflame it causing compression.
 Symptoms -1)ottorrhoea(discharge).
2)otalgia(no ear pain).
 Treatment –myringotomy(incision to
tympanic membrane).

28.  Facial nerve and its relation with the
middle ear

29. TRAUMA:
 1)fractures of temporal bone due to
injury in accidents.
 2)birth injury to the facial nerve at the
time of delivery due to application of fore
ceps.
reason :it remains unprotected after
its exit through stylomastoid foramen.
investigation –CT Scan

30. CONGENITAL FACIAL
PALSY:
 It is mainly due to application of
foreceps during delivery.

31. TUMOUR:
 The bells palsy may be due to tumour’s
which compress the the nerve along its
course.
investigation -1)Tomography.
2)MRI(to locate tumour)
3)CT Scan

32. BELL’S PALSY DUE TO
COMPRESSION:

33. OTHER CAUSES:
1)Diabetes milletes
2)Nervus sarcoidosis
3)Moebius syndrome
4)Guillaine –barre syndrome
5)pregnancy

34.  Diabetes milletus –the person with DM is more
susceptible for otitis inflammation.
 Sarcoidosis –abnormal collections of
inflammatory cells which transform as nodules
is known as sarcoidosis.As it occurs in facial
nerve it is known as nervus sarcoidosis.
investigations –angiotensin converting
enzyme levels.
treatment -1) Ibuprofen or aspirin.
2)if it progress-prednisolone.

35.  Moebius syndrome –This can be taken as
congenital malformity.
 under development of 7th&6th cranial nerves is
known as moebius syndrome.
symptoms -1)cannot close eye.
2)no facial expression.
3)complete facial palsy.
treatment -1)tarsorraphy-(eye).
2)smile surgery-for fascial
expressions(grafting of muscles from thigh to
corners of mouth).

36. DIFFERENCE BETWEEN
FACIAL PALSY&BELL’S
PALSY
FACIAL PALSY BELL’S PALSY
1)Cause can be known
(infection,trauma,
tumour).
2)Permanent(lasts for
years to life).
3)need surgical
treatment.
4)Site of affection
depends upon
UMN&LMN Lesions.
1)It is idiopathic(may de
velop suddenly).
2)Temporary(permanent
cure with in 3 months in
90% of cases).
3)Without treatment or
surgery regains facial
function.
4)It is mainly due to
LMN Lesions.half side
of the face is totally
affected.

37. Tests for facial palsy:
 Ask the patient to show his teeth.
 Ask the patient to puff his cheeks.
 Ask the patient to close his eyes against
resistance.
 Ask the patient to lift his eyebrows.

38. TESTS:

39. TREATMENT:
 Brow ptosis correction – direct brow lift,endoscopic
brow lift.
 Eye lid weight placement – occuloplastic
management for lagopthalmus.
 Static facial suspension – by using facial slings from
zygomatic/temporalis arch to nasolabial fold & oral
commisure.
 Extra nasal valve repair – facia lata sling from alar
base to temporalis facia to open extra nasal valve.
 Cross Face Nerve Transplant(CFNT) – It is most
advanced.
 It is making continuity between paralysed&normal
facial nerves by means of bridge grafts.

40. BROW PTOSIS
CORRECTION:

41. EYE LID WEIGHT
PLACEMENT:

42. STATIC FACIAL
SUSPENSION:

43. CROSS FACE NERVE
TRANSPLANT(CFNT):