Effect of Virechana Karma on Functional Outcome in a Case of Pakshaghata (Post-Stroke Hemiplegia)

Pakshaghata (hemiplegia), described under Vatarogas in Ayurveda, closely correlates with post-stroke hemiplegia. Stroke is a major cause of long-term disability, and early interventions are crucial to improve functional outcomes. Classical Ayurvedic texts recommend Virechana Karma (therapeutic purgation), particularly Snigdha Virechana (therapeutic purgation using fat), as a primary line of management in Pakshaghata. Case Presentation: A 60-year-old female presented 24 days after an ischemic stroke with left-sided hemiplegia, slurred speech, and severe dependence in activities of daily living. MRI confirmed an acute infarct involving the right cerebral hemisphere. Snigdha Virechana was administered using Gandharvahasthadi Erandataila following classical preparatory procedures. Outcome: Functional status was assessed using clinical parameters and the Barthel Index before and after treatment. The Barthel Index score improved from 20 to 65, indicating progression from total dependence to moderate dependence. Improvements were also noted in muscle strength, sitting and standing balance, walking ability, speech, and pain. Conclusion: This case suggests that Virechana Karma may contribute to significant functional improvement in post-stroke hemiplegia. Virechana may serve as a foundational therapeutic intervention before other Ayurvedic modalities in Pakshaghata management.