Importance of Rookshana Karma (dehydrating therapy) in the management of transverse myelitis
An 18-year-old male patient having indwelling catheter in situ reported with the complaint of inability to move his legs and no sensation below his navel []. He also told that his legs seemed to be cold. He was having loss of appetite. He could not hold the urge of defecation.\nOn asking about the history of the same, he stated that he was alright till evening of 8 April 2010 and then he felt feverish and developed pain all over the body. He took some medicine for the same from his family doctor. He woke up late in the morning and was unable to stand up by himself. He stood with support and tried to walk. During the walk, he felt that his legs were not in his full control. He had not voided any urine since morning. In the evening, along with his relatives, he again consulted the other doctor who then referred him to higher center.\nHe got admitted to the hospital on the next day with the complaint of no sensation in lower half of the body as well as insensitivity to touch from lower part of neck to toe. He was also having the feeling of tightness around the abdomen.\nLumbar puncture was done on the same day, which showed increased polymorphs. On 15 April 2010, CT-head was done and it was normal. He also faced some respiratory problems and so was on intermittent oxygen inhalation therapy from 12 to 18 April 2010. On 17 April 2010, MRI cervico-dorsal spine with MRI brain was done, findings of which were as follows.\nLong segment T2 hyper intensity of the cervicodorsal spinal cord from the C3 level onward. Suggestive of myelitis.\nTherefore, the present case had been diagnosed as that of transverse myelitis and came to us after two months of acute attack. At that time, he was having total paraplegia, no sensation below umbilicus, and other typical features of transverse myelitis such as bladder–bowel dysfunction, feeling of tightness around abdomen, and a bed sore on the sacral region.\nSome of the above-mentioned presentations of the patient resembled the sign and symptoms of a disease named as Urustambha (spasticity of thighs) in Ayurvedic classics.[] On having a critical view, some of the features of transverse myelitis and Urustambha are found very close to each other and can be correlated[–] []. On the other hand, many other features of transverse myelitis and Urushtambha are also there that cannot be correlated[] [].