April 02, 2015

Kumbhakaran: The Sleeping Giant With Brain Tumor

Everyone knows who Kumbhakarna was – The sleeping giant who was the brother of our not so favourite character from the Ramayana, Raavana. He was the Raavanas secret weapon, the fat brother who was huge and had an even bigger temper, and possibly even bigger appetite. 

Legend goes that Kumbhakarna had been granted a boon and could ask Bramha the creator for whatever he wanted. Fearing the worst, Indra had twisted his tongue in the last moment when Kumbhakarna had to make his wishes. So when Kumbhakarna had asked Bramha for "Indrasaana" (the home of Lord Indra), Brahma heard it as "Nidrasaana" (Bed for sleeping) and when he asked for "Nirdevatvam" (destruction of Devas), it was misheard as "Nidravatvam" or sleep. What happened after that we all know the story, Kumbhakarna would sleep for unusually long periods (months) and wake up with an unstoppable hunger and grumpy angry mood. Not the ideal brother is it? Unless you’re fighting Rama that is! 

The story wasn’t really a myth and Indian doctors claim that the symptoms shown by the big guy are legit. Doctors say that he suffered from significant polyphagia and weight gain that occurs because of the involvement of the ventromedial nucleus of the hypothalamus bilaterally. Sounds really intense! In simple words, our sleeping giant suffered from hypothalamic obesity.  

Here are a few symptoms associated with the condition – 

(1) Assemblage of pressure symptoms in form of headaches or vomiting. 
(2) Endocrine features such as impaired reproductive functions and growth, and diabetes. 
(3) Neurological features like Somnolence ( Desire to sleep for insanely long periods). 

This condition is caused by a tumor in the brain or a head injury or even tuberculosis, but most commonly, a tumor. Doctors today claim that they could have cured this abnormal condition that occurs in the brain with a simple surgery, to remove the tumor. A certain endocrinologist said that he had come across a 50 year old patient with identical symptoms. In the case of hypothalamic obesity, the patient suffers from strong desires of sleeping for unusually long hours and waking up hungry, abnormally hungry. This is also complimented with anger bouts and frustration, both depicted by Kumbhakarna which made him so fierce. 

The obesity is attributed to an extraordinarily slow metabolic rate, which is found to be the case with most such patients and probably what Kumbhakarna suffered from too. He is said to have had 2,000 pitchers of water once on waking up, and symptoms of hypothalamic obesity also include polydipsia. Kumbhakarna's symptoms can also be explained by another hypothalamic syndrome called Klein-Levine syndrome. 

In this condition periodic episodes of somnolence, hyperphagia and hyper-sexuality along with other behavioral and cognitive difficulties are common among the patients. Another reason why this condition fits too is because patients of the Klein-Levine syndrome are unable to articulate what they want to say. Like asking for sleep instead of the throne of gods! 

 In my opinion Kumbhakarna needed a good day at the doctors clinic, with a couple of CT scans and a good neurologist. 

If you know or see anyone with similar symptoms, you don’t have to guess what’s wrong now!

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