Management of Nasya-induced pyrexia in a patient with refractive error and migraine: a case report

A 23 year old young lady was admitted for Ayurveda treatments of her refractive error coupled with migraine. She was put on Shadbindu Taila Nasya, 24 drops in both her nostrils immediately the next day. Within 6 h of performing Nasya, the patient started developing pyrexia which was initially of low grade, and later, within 6 h, went on to high-grade. Nasya was suspended, and rescue Ayurveda medicines were started but had no improvement. The patient later self-medicated an antipyretic drug, and with a single dose, the high-grade pyrexia came down to normal. Naranjo adverse drug reaction probability scale recording gave a score of six, which shows that the AE could be probably due to Nasya with Shadbindu Taila. This case report adds evidence to the medical database of under-reported/poorly reported adverse effects (AE) cases of Nasya therapy. It shows that Nasya is not a 100 % complication and adverse effect free treatment, but rather has to be done with extreme caution. This case report highlights that effective Ayurveda principle based preparatory treatments are also to be done before initiating Nasya to minimize the chances of adverse effects. This case report also suggests practicing a test dose of Nasya, before initiating a high dose, so as to detect adverse events and prevent severe complications.