Pittaja Bhrama (Vertigo of Pitta Origin): An Ayurvedic Review With Contemporary Correlation

Background: Pittaja Bhrama is a Pitta-dominant subtype of Bhrama Roga characterised by rotational vertigo, burning sensation, and neuro-psychological instability arising from vitiation of Pitta Dosha, with secondary Vata involvement and Rajas (psychic) aggravation affecting Manovaha Srotas and Mastishka. Objective: To systematically review the etiopathogenesis, clinical features, differential subtype analysis, and management of Pittaja Bhrama through classical Ayurvedic texts, and to establish contemporary pathophysiological and clinical correlates with vestibular migraine, GERD-related vertigo, and psychosomatic neurovestibular disorders. Methods: A narrative review of primary Ayurvedic classical texts — including Charaka Samhita, Sushruta Samhita, Ashtanga Hridaya, Madhava Nidana, and Bhaishjaya Ratnavali — was conducted. Contemporary biomedical literature on vestibular migraine, neurovestibular physiology, and HPA axis dysregulation was reviewed for conceptual integration. Results: Pittaja Bhrama presents with intense rotational vertigo, cephalic burning (Daha), photopsia, nausea, tachycardia, and psychomotor irritability. Its pathogenesis follows a defined Samprapti from Pitta Prakopa through systemic Prasara, Sthanasamshraya in Mastishka and Manovaha Srotas, and culminates in Indriya Vibhrama with Vata Anubandha. Management encompasses Pitta Shamana, Agni Deepana, Panchakarma (Virechana, Nasya, Shirodhara, Takradhara), herbo-mineral formulations, and Rasayana therapy. Conclusion: Pittaja Bhrama is a clinically coherent Ayurvedic diagnostic category with credible pathophysiological correlates in contemporary vestibular medicine. An integrative framework combining Shodhana, Shamana, and Rasayana offers a rational evidence-informed approach. Prospective clinical trials with validated outcome measures are warranted to build a robust evidence base.