Patient Baseline
A 41-year-old male software professional with generalized myasthenia gravis showing oculo-bulbar predominance presented with diurnal fluctuation of symptoms: right-greater-than-left ptosis with evening diplopia, nasal speech, chewing-related fatigue, intermittent dysphagia for solids after 6–8 pm, and proximal limb fatigability; single-breath count was 22. Objective assessments showed MG-ADL 9/24 and QMG 13/39. Serology revealed AChR antibodies positive (10.8 nmol/L), repetitive-nerve stimulation demonstrated an 18% decrement, and CT chest showed no thymoma.
Panchakarma Protocols
- Days 1–3 Deepana-pācana diet; Mridu Abhyanga + Nādi Sveda.
- Days 4–14 Mātrā Basti (daily nights); Śāṣṭika Śālī Pinda Sveda (alt. days); Mṛdu Nasya (7 days); Śirodhārā (2–3 sessions).
- Days 15–21 Continue abhyanga/sveda; finish Śirodhārā (total 5); begin gentle isometric ocular breaks and energy-budgeting at work. Checkpoint (Day 21): MG-ADL → 5; ptosis latency ~90 sec.
- Follow Up Schedules
Improvements Observed
- Ocular: Evening ptosis and diplopia reduced; fatigue latency >2 minutes; reading time extended by ~45 minutes without eye strain.
- Bulbar: Chewing endurance ×3; decreased nasal speech; rare dysphagia episodes.
- Limb strength: MRC improved by one grade proximally; stair-climb with one brief pause (earlier two).
- Fatigue & QoL: Day-end fatigue score (0–10) 7 → 3; sleep onset latency ~45 min → ~20 min.
Treatment Outcome
Over 12 weeks, with an integrative Ayurvedic plan co-managed with Neurology, the patient showed clear functional gains: MG-ADL improved from 9 to 3 and QMG from 13 to 6; ptosis-fatigue latency rose from ~20 seconds to >2 minutes mid-day; chewing endurance increased from ~60 to ~180 seconds without spill or nasal regurgitation; and the single-breath count improved from 22 to 32. Neurology optimised medications, reducing pyridostigmine to 60 mg TID and tapering prednisolone to 5 mg OD.