Skanda Graha and Skandapasmara Graha Afflicting Children

By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S

Grahas are psychosomatic diseases afflicting children due to evil forces. Graha is a name given to the planets or unseen organisms. It was believed that some unknown and invisible entities would produce a few diseases and they were called Graha’s.
When compared with the modern day diseases the Graha’s can be compared to the micro-organisms like viruses, bacteria etc. Graha’s were said to bother the children more than the adults.

Table of Contents

Signs and symptoms of Skanda Graha

Tears from one eye
The child often jerks the head violently
One side of the body or parts of one side of the body become function-less
Stiffness of the body parts
Sweating
The neck becomes curved or bent
Grinding of teeth
Rejects breast milk
Feared
Cries making awkward sounds
Face becomes twisted
Vomiting of saliva excessively
Child gazes upwards
Smell of muscle-fat or blood emitted from the body of the child
Terrified
Clenches fists
Constipation
Movement of one eye, one cheek and one eyelid
Redness of both eyes
Deformities of body parts
Death

Tremors (Yoga Ratnakara)
Undistinguished weeping (Yoga Ratnakara)
Read – Symptoms That Hint Towards Different Diseases In Babies

Sanskrit Verses

Modern correlation

This condition can be closely compared to ‘hemiplegia with facial paralysis in children’.

We do not find many instances when we find both hemiplegia and facial paralysis symptoms found at the same time, in a given child. The below mentioned conditions shall be considered in comparative study with its Ayurveda counterpart.

Alternating hemiplegia – also known as crossed hemiplegia is a form of hemiplegia in which we can find ipsilateral and contralateral presentation in different parts of the body. Superior alternating hemiplegia i.e. Weber Syndrome presents with contralateral hemiparesis of limb and facial muscles along with weakness in one or more muscles that control eye movement on the same side. There is loss of eye movement due to damage of oculomotor nerve fibers. There is increased weakness in upper and lower extremities. Another type of this hemiplegia i.e. Middle alternating hemiplegia or Foville Syndrome presents with weakness of the extremities accompanied by paralysis of the extraocular muscle, on the opposite side of the affected extremities.

Alternating Hemiplegia of Childhood (AHC) – is a rare neurological disorder that usually occurs in children before 18 months of age. It causes recurrent episodes of hemiplegia that involves one or both sides of the body, multiple limbs or a single limb. Paralysis may affect different parts of the body at different times. The symptoms disappear during sleep and return on awakening. Many children display some degree of developmental delay, abnormal eye movements, uncontrolled limb movements and seizures.

Central facial palsy – presents with paralysis of lower half of one side of the face. It often occurs in patients who are hemiplegic. Symptoms include dysfunctions in the facial expressions, difficulty in communication and impairment of sucking, swallowing and talking.

Facial Paralysis in Children – Since the facial symptoms dominate the picture of Skand Grah, we shall discuss about the facial paralysis in brief. It is caused by damage to the seventh cranial nerve i.e. facial nerve. This nerve governs the sensation and movement of all the muscles in the face. Damage to this nerve causes inability to move one or both sides of the face. This affects the child’s ability to convey emotion through facial expression, blink, speak and eat. It may be caused due to Bell’s palsy, trauma during child birth, head injury, Moebius syndrome or tumors.

Symptoms include drooping on one side of the face due to muscle weakness, asymmetrical smile, inability to blink, drooling, difficulty feeding and speech problems, most of which are seen in children afflicted by Skanda Graham.

Congenital facial paralysis – is uncommon. When it is present, it might cause multiple problems for the newborn. Asymmetrical facial movement, difficulty in nursing and incomplete eye closure is common symptoms. On long run it might affect the speech, expressions and mastication in the child. This may be traumatic or developmental, unilateral or bilateral and complete or incomplete paralysis.

Treatment

1. Internal medication

Rasna – Devadarvadi Ghrita / Ksheera Pana

Ghee processed with paste of Pluchea lanceolata or Cedrus deodara and milk should be given to drink. Alternatively milk processed with the same herbs and herbs having sweet taste should be given for drinking.

Dashamuladi Ghrita Pana

The ghee processed with milk mixed with the decoction of Dashamula or paste of Kakolyadi group of sweet tasting herbs is given to drink.
Read – Which Ayurvedic Medicines Are Not Safe For Children? How To Know?

2. External measures

a. Anointment

Gugguluvadi Churna Lepa

Soft powder of the below mentioned herbs should be prepared and applied on the body of the child –

Guggulu – Commiphora mukul
Elavaluka – Prunus cerasus
Manashila – Realgar
Haratala – Orpiment
Manjishta – Rubia cordifolia
Ushira – Vetiveria zizanioides
Rasna – Pluchea lanceolata
Aguru – Aquilaria agallocha
Devadaru – Cedrus deodara
Shriveshtaka – Clitoria ternatea
Harenu – Pisum sativum
Girikadamba – Neolamarckia cadamba
Sandalwood – Santalum album
Read – Infant Care As Per Ayurveda: Initial 6 Months

b. Bath

Vatahara Kwatha Snana

Bath should be given with the decoction prepared with leaves of vata mitigating plants.
Read – How To Make Ayurvedic Herbal Bath Powder At Home?

c. Massage

Vata Nashaka Taila Abhyanga

Oil processed and prepared with the decoction of the roots of Vata mitigating herbs and fragrant herbs should be used for massage.

Kantakaryadi Taila Abhyanga

Oil prepared with the below mentioned herbs shall be used for giving massage –

Kantakari – Solanum xanthocarpum
Brihati – Solanum indicum
Punarnava – white and red varieties of Boerhavia diffusa
Renuka – Vitex agnus-castus
Pippali – Piper longum
Musta – Cyperus rotundus
Khadira – Acacia catechu
Vacha – Acorus calamus
Shankhanabhi – kind of a shell
Sarala – Pinus roxburghii
Sarpasugandha – Rauwolfia serpentine
Devadaru – Cedrus deodara

Sarvagandha Dravya Siddha Taila Abhyanga

Massage shall be given with the oil prepared with ‘Sarvagandha Dravyas’ i.e. fragrant herbs, sura-manda i.e. scum or froth of bear, Mahanimba (Melia azedarach) etc.
Read – Oil Massage To Baby: Precautions, Method, Ayurvedic Oil Combinations

d. Fumigation

Vachadi Dhupa

Fumigation should be given with the below mentioned things –

Vacha – Acorus calamus
Gunja – Abrus precatorius
Skin of snake
Mustard
Hairs of camel, goat, sheep, horse and cow
Ghee

Sarshapadi Dhupa

Fumigation with the powder of the below mentioned ingredients should be given –

Mustard seeds
Rala – Shorea robusta
Kushta – Saussurea lappa
Hingu – Asafetida
Guggulu – Commiphora mukul
Read – Guggul Benefits, Usage, Dose, Side Effects, Research

Sarpagandhadi Dhupa

Fumigation is given with Rauwolfia serpentine, nails and hairs of goat.

e. Parishechana – showering

Vata Nashaka Parishechana

Sprinkling done with the decoction prepared from the leaves of vata mitigating herbs like Bilwa, castor or Rasna. The roots of the same herbs shall be used to process sesame oil and this oil shall be used to give full body massage.

3. Ritualistic measures

a. Bheshaja Dharana – wearing medicaments

a. The below mentioned herbs should be tied in a bolus and tied in the neck of the child afflicted by Skand Graha –

Guduchi – Tinospora cordifolia
Durva – Cynodon dactylon
Shami – Prosopis cineraria
Bilwa Kantaka – thorns of Aegle marmelos
Indravaruni – Citrullus colocynthis
Read – Bael Root, Fruit And Stem, Uses, Research, Remedies, Side Effects

b. The seeds of the below mentioned should be tied in a bolus and tied around the neck of the child. Alternatively the seeds shall be tied to the arm or wrist.

Nakuli – Rauvolfia serpentine
Ajagandha – Cleome gynandra
Tikta koshataki – Luffa acutangula
Indravaruni – Citrullus colocynthis
Shatavari – Asparagus racemosus
Sahadevi – Vernonia cinerea
Punarnava – Boerhavia diffusa

b. Bali – sacrifice

The below mentioned should be offered as sacrifice to the Skanda Grah –

Red garland
Red anointments
Red clothes
Red banners
Gems
Sesame
Varieties of dishes
Curds
Ghee
Honey
Parched grains
Meat
Fish
Fermented drinks, wine
Peacock
Cock
Red colored rice etc

These should be sacrificed in the main roads or at the roots of the latex yielding trees.

Later the child should be given a bath on the river bed. Following this, the below mentioned hymn should be recited.

Read – Ayurvedic Home Remedy For Baby Care – A Traditional Method

c. Havana – fire worship

At the night, the fire should be lit up and should be offered with oblations of honey and ghee after chanting the below mentioned hymn –

For three nights, the mother / wet-nurse and the child should be bathed with water consecrated by ‘Gayatri Mantra’ hymn. The mother and child shall be seated at the junction of four roads.
Read – Analysis Of Effect of Mantras On Health And Nadi

d. Marjana – Raksha Sutra

The child should be subjected to sprinkling / body wash with the water consecrated with the above mentioned hymn, thrice in a day. A carrying girth made up of consecrated threads should be tied around the wrists of the child. This is said to protect the child from the evil spirits.

Skandapasmara Graha

Signs and symptoms

Child suddenly goes unconscious and suddenly gets back to consciousness
Throws away his hands and legs in a bizarre way as if dancing
Voids feces and urine while throwing his limbs
Bowing of body
Severe yawning
Frothing from the mouth

b. Symptoms from Yogaratnakara

When child loses consciousness, he vomits foam
When child gains consciousness, he cries and screams a lot
Smell of pus and blood from the body

c. Symptoms from Ashtanga Samgraha

Loses consciousness often
The child pulls his hairs
The neck gets crooked
Bending of body
Yawning
Repeated voiding of feces and urine
Vomiting of foam
Eyes gazed in upward direction
Rapid movements, as if dancing, of hands, eyebrows and feet (lower limbs)
Bites the breasts of his mother or his own tongue
Agitated
Fever
Sleeplessness
Emits smell of pus and blood from the body
Read – Your Child Does Not Eat Well? Causes, Ayurveda Solutions

Sanskrit Verses

Modern Correlation

The main symptoms of Skandapasmaram resembles ‘epileptic attacks in children’ explained in modern texts.

Epilepsy is quite common in childhood. Epilepsy causes seizures which begin in the brain. Most often it is found that adults with epilepsy have had their first episode of seizure in childhood or adolescence. According to the Epilepsy Foundation, 2/3 children with epilepsy outgrow seizures by the time they reach their teenage. Good and comprehensive care help many children get rid of seizures and in prevention of side effects. Seizures are common in the first year of life.
Read – Epilepsy – Ayurvedic Understanding And Its Treatment

Types of childhood epilepsy and symptoms

Focal seizures and generalized seizures are the two main types of seizures.

Focal seizures / partial seizures – affect only one side of the brain. The child experiences an aura before seizure. This signals the arrival of seizures. The auras of seizure may include changes in hearing, vision or smell, unusual feelings, such as fear, euphoria or sense of déjà vu. Focal aware seizures affect a specific muscle group such as those in fingers or legs. There is no loss of consciousness. The child having focal aware seizure may appear frozen. The child is unable to respond but can usually hear and understand things which occur in the surroundings. Nausea, pale skin and sweating are also present. Focal impaired awareness seizures cause loss of consciousness or awareness of surroundings. Symptoms like crying, laughing, staring and smacking of lips are present.

Generalized seizures – affect both sides of the brain. It usually causes loss of consciousness. After the attack, the children are sleepy and tired. This is called postictal state. It is of the below mentioned types –

Absence seizures / Petit-mal seizures – presents with brief loss of consciousness. Staring, rapid blinking of eyes and facial twitching are the other symptoms. This is most common in age groups of 4-14 years. The seizures last less than 10 seconds. There is absence of postictal state.
Atonic seizure / drop seizures – there is sudden loss of muscle tone. The child may fall down or limp and stop responding. The attack usually lasts less than 15 seconds.
Generalized tonic-clonic seizure (GTC) / Grand mal seizure – first there is contraction, then straightening and then shaking of child’s body and limbs. Later the muscles contract and relax. Finally there is postictal period. Here the child becomes tired and confused. The attack usually last for 1-3 minutes.
Myoclonic seizure – causes sudden jerking of muscles and the seizures last for 1-2 seconds. There may not be loss of consciousness.
Read – Nocturnal Enuresis – Bed Wetting In Children: Treatment

Childhood Epilepsy Syndrome

Benign Rolandic Epilepsy of Childhood – occurs between 3-10 years of age and affects about 15% of children with epilepsy. Focal seizures might occur at night and may develop into GTC. Seizures may rarely occur during wakefulness. They usually involve twitching of the face and tongue.
Childhood absence epilepsy – usually affects children under 16 years of age. It begins between 4 and 10 years of age. The caregivers may not take a note since the absence seizures are very brief.
Infantile spasms / West Syndrome – usually begin before a child is 1 year of age. There are brief spasms or jerking in one or more parts of the body. The spasm occurs in clusters. This can affect infants who have had a brain injury. Many children with this syndrome have learning difficulties or behavioral problems. They may also develop another syndrome called Lennox-Gastaut Syndrome.
Juvenile Myoclonic Epilepsy – begins between 12 and 18 years of age. This causes different types of seizures, including myoclonic seizures, tonic-clonic seizures and absence seizures. Flashing lights can trigger seizures. They may also occur shortly after waking up. It is the most common generalized epilepsy syndrome. It often continues into adulthood. Medication can control seizures in up to 90% cases.
Landau Kleffner Syndrome – is a rare childhood disorder, begins between 3 and 7 years of age. It causes difficulties in understanding language and verbal expression. The child may also have behavior problems. About 70% children with LKS have obvious seizures. The seizures are usually focal.
Lennox-Gastaut Syndrome – usually begins between 3-5 years of age and causes various kinds of seizures. Many children will have learning and behavior problems.
Temporal Lobe Epilepsy – is the most common form of focal epilepsy. Symptoms usually occur between 10-20 years of age.
Read – My Child’s Intelligence Is Decreasing. 9 Tips To Improve

Causes of childhood epilepsy

In many cases no cause may be identified. Below mentioned are the potential causes or contributing factors of childhood epilepsy –

Developmental disorders, autism
Genetic types of epilepsy
Infectious diseases like meningitis etc
Head trauma
Tumors / cysts in the brain
High fevers (febrile seizures)
Oxygen deficiency before or during birth
Maternal infections and poor nutrition during pregnancy

Common trigger factors for childhood seizures

Excitement
Deficit sleep
Flickering / flashing lights
Missing medication for seizures
Music, loud noises etc
Read – Charaka Apasmara Nidana: 8th chapter

Diagnosis

Below mentioned are the tools of diagnosis of childhood epilepsy –

Complete medical and family history
Details of episodes of seizure
Thorough physical examination of the child
Blood tests
Brain scans and measurements – CT scan, MRI scan & EEG
Read – Ayurvedic Treatment For ADHD – Herbs, Therapies, Medicines, Remedies

Treatment

Medications – antiepileptic drugs to control the symptoms. These do not control seizures in all children.

Ketogenic diet – to control the seizures should be planned with the help of doctor and dietician.

Neuro-stimulation – done when the epilepsy do not respond to the drugs. They are of 3 types – vagus nerve stimulation, responsive neuro-stimulation and deep brain stimulation.

Surgery – is some cases surgery may be needed to remove a portion of the brain. They may prevent or reduce seizures.
Read – Charaka – Apasmara Chikitsa – 10th chapter

Ayurvedic treatment

1. Internal medication

Kshiri vriksha kwatha and Jivaniya Kalka Sadhita Ghrita Pana

Ghee prepared with the decoction of latex yielding trees or paste of Jeevaniya group of herbs should be given for oral consumption.

Kakolyadi Gana Siddha Ghrita Pana

Ghee prepared with decoction of Kakolyadi group of herbs and milk explained by master Sushruta should be given for oral consumption.
Read – When To Consume Ghee? Before Or After Food?

2. External measures

a. Anointment

Skandagrahokta Lepa – anointment explained in the context of child afflicted with Skanda Graha should be used in this context too –Gugguluvadi Churna Lepa

b. Parishechana / Snana – showering and bath

Durvadi Kwatha Parishechana / Snana

Showering and bath should be given to the child with decoction prepared using the below mentioned ingredients –

Durva – Cynodon dactylon
Bilwa – Aegle marmelos
Shirisha – Albizia lebbeck
Musta – Cyperus rotundus
Tulasi – Ocimum sanctum

c. Abhyanga – massage

Sarpasugandhadi Taila Abhyanga

Oil processed with the below mentioned ingredients should be used to give body massage to the afflicted child –

Paste of Rauvolfia serpentine
Paste of Cedrus deodara
Kushta – paste of Saussurea lappa
Musta – paste of Cyperus rotundus
Urine of cow
Urine of goat
Read – Uses Of Animal Urine As Per Ayurveda

d. Fumigation

Fumigation should be given to the child with the below mentioned ingredients –

Feces of vulture
Feces of owl
Body hairs of bull
Human hairs
Nails of elephant
Ghee

3. Ritualistic measures

a. Raksha Sutra – protective measures through wearing / tying medicament

The below mentioned herbs shall be tied to the limbs, neck or head of the afflicted child –

Anantamula – Hemidesmus indicus
Kukkuti – Mallotus tetracoccus / Bombax ceiba / Physalis minima / Luffa echinata
Kunduri – Coccinia grandis
Manjishta – Rubia cordifolia
Shweta kamala – white variety of lotus etc

b. Bali and Snana – Sacrifices and bathing

Raw or cooked meat, blood, curds and spirituous liquor should be offered as sacrifice at the roots of Banyan tree.