Epilepsy+(Dian+Xian)

This conditions covers epilepsy and other conditions not considered epilepsy by Western medicine. [for this reason Flaws prefers the term “epileptiform disease”] It is characterized by essence spirit abstraction. If it is severe, there is sudden falling and loss of consciousness. Foaming drool may be spit from the mouth, the eyes may stare straight upward, and there may be convulsions of the four limbs.

Relevant Western Diseases: Generalized epilepsy, severe hysterical attacks, brain injury, poison, tumors or vascular disease, Metabolic or endocrine system diseases

Differential Diagnosis: A. Seizure Disorders B. Cerebrovascular Accident (CVA) C. Myocardial Infarction D. Transient Ischemic Attack (TIA) A. Alcohol or illicit substance intoxication or withdrawal B. Side effects of medications A. Conversion Disorder B. Anxiety Disorders C. Disorders of impulse control D. Borderline Personality Disorder (BPD) E. Histrionic Personality Disorder (HPD) F. Schizophrenia and other Psychotic disorders G. Major depressive episode H. Pseudoseizures
 * Medical Disorders:**
 * Effects of Substances:**
 * Psychiatric Disorders:**

TCM Etiology & Pathogenesis: “Causes of epileptiform condition in Chinese medicine are divided into pre-heaven or prenatal, and post-heaven or postnatal. If the mother experiences great fright during pregnancy, this may damage the fetus causing essence damage and kidney depletion In that case, after birth kidney Yin may fail to control liver Yang which becomes hyperactive and may engender wind. When this wind stirs internally, it may give rise to epileptiform conditions. In terms of the later heaven mechanisms, if the seven affects are unregulated, and especially if there is great fright and fear, the Qi mechanism may counterflow and become chaotic…If the Qi mechanism becomes chaotic and counterflows, the viscera and bowels will not be harmonious and thus easily suffer detriment” 1

“The pre-heaven factor is a key etiological factor for this disease. Emotional disharmony an also be a cause. As discussed in the [Su Wen], abnormal Shen-emotional situations can be derived from pathological Qi mechanism. Bran injury is another factor leading to the disease. [Dan Xi Xin Fa] suggests that the phlegm obstructing is the key pathologic factor. The disease can develop in the fetal period by frightening of the mother during pregnancy. Emotional disharmony causes many types of dysfunction of the Qi mechanism and generates phlegm, fire stagnation and wind. Injury to the head directly damages the Brain Shen and leads to stagnation. Broken brain meridians can be found in severe cases and remain in the Xian syndrome.”2

Prognosis: Recurrent attacks can damage Brain Shen and create the severe consequences of Shen disturbances or extreme weakness. Generally the prognosis depends on the severity of injury to the brain. Today more information can be gained by referring to Western medical exams.

Diagnosis: J. Relate to medical history, birth experience or past injury K. Sudden onset and loss of consciousness with seizures and later waking up L. History of recurrent attacks M. Accompanied by Shen emotional symptoms N. Generalized epilepsy diagnosed in Western medicine O. Imaging, lab, and ECG Should have B, but mostly requires Western medical information to confirm

TCM Pattern Differentiation: Liver Wind and Phlegm Turbidity 1,2 During episode: sudden falling, consciousness is not clear, there are convulsions, and there may be spitting of drool, eye roll back, close up mouth tightly, general twitching & shaking of body. Sounds like the bleating of sheep or the grunting of pigs may be heard (sharp tones). May be incontinence of urine or defecation. Normal times: May be either prodromal dizziness, vertigo, clouded mind, delirium, chest oppression, and lack of strength or there may be no marked prodromal symptoms. -LR-3, ST-40, PC-6, Yao Qi (empirical point 2 cun above tip of coccyx) Draining technique1 -LR-3, ST-40, PC-6, CV-12, GB-34, PC-5, Yin Tang, GV-262 - [Shi Chang Pu, Dan Nan Xing, Ban Xia, Tian Ma, Quan Xie, Jiang Can, Yuan Zhi, Shi Jue Ming, Zhu Ru, Zhang Zhu Mu, Gou Teng] 2
 * Tongue:** may be shaky or deviated to one side, thick white coat
 * Pulse:** wiry, slippery
 * Treatment Principles:** Flush phlegm and extinguish wind, open the orifices and stabilize epilepsy
 * Acupuncture Treatment:**
 * Herbal Treatment:**
 * -** Ding Xian Wan Jia Jian1 - [Zhu Li (10-15g.), Shi Chang Pu (12g.), Dan Nan Xing (10-12g.), Ban Xia (10g.), Tian Ma (10g.), Quan Xie (1.5-3g.), Jiang Can (6-10g.), Fu Shen (10g.), Yuan Zhi (10g.)] 1
 * Modifications:** More phlegm1: + Xing Ren, Jie Gen

Liver Fire and Phlegm Heat 1,2 During episode: clouding or sudden loss of consciousness, convulsions, shouting out, and spitting of drool. Normal times: emotions are tense and agitated and there is heart vexation, insomnia, spitting of hard-to-expectorate phlegm, red face and eyes, body is hot, dry mouth w/ bitter taste, constipation, dark colored urination -LR-2, HT-7, PC-6, St-40, Yao Qi (empirical point 2 cun above tip of coccyx) Draining technique1 -LI-1, LI-4, LR-2, ST-40, ST-44, ST-45, Ying Tang, HT-7, GV-262 -Long Dan Xie Gan Tang He Di Tan Tang Jia Jian - [ Long Dan Cao (15-20g.), Huang Qin (10-12g.), Zhi ZI (10g.), Ba Xia (10g.), Ju Hong (6-10g.), Dan Nan Xing (10-12g.), Shi Chang Pu (12g.)] 1 -[Qing Meng Shi, Xiao Shi, Dan Nan Xing, Tian Zhu Huang, Ban Xia, Zhang Zhu Mu, Shue Jue Ming, Zhu Ru, Jiang Chan, Da Huang, Huang Qing, Quan Xie] 2 Headache w/ profuse phlegm1: + Shi Jue Ming, Gou Teng, Zhu Li, Di Long Phlegm fire congestion, repletion & constipation1: + ST-36, ST-25
 * Tongue:** red tongue, slimy yellow coat
 * Pulse:** bowstring, slippery, rapid
 * Treatment Principles:** Clear the liver and drain fire, transform phlegm and open the orifices
 * Acupuncture Treatment:**
 * Herbal Treatment:**
 * Modifications:**

Yin Vacuity-Yang Hyperactivity 1,2 Epileptiform attacks enduring for days, impaired memory, low back pain, 5-palm heat, insomnia, dry mouth, thirsty especially at night, dizziness, dry stools/constipation, may have hot flashes -Drain: LR-3; Tonify: SP-6, BL-18, BL-23, HT-71 -LR-3, LR-8, KI-3, KI-6, SP-6, HT-7, PC-6, GV-20, GB-202 - [Sheng Di, Shu Di, Shan Yao, Du Zhong, San Zhu Yu, Sih Jue Ming, Zhen Zhu Mu, Niu Zhen Zi, Han Lian Cao, Sang Shen, E Jiao, Gui Ban Jiao] 2 Severe Yin vacuity/Yang hyperactivity1: + Mu Li, Bie Jia Heart spirit restlessness1: + Bai Zi Ren, Ci Shi Severe phlegm fire1: + Bei Mu, Tian Zhu Huag, Zhu Ru Vexatious heart heat1: + Zhi Zi, Lian Zi Xin; + PC-5 Dry stools1: + Xuan Shen, Huo Ma Ren; + BL-25, ST-25 Lassitude of spirit, somber complexion, enduring condition1: + He Che Da Zao Wan; + BL-20, ST-36
 * Tongue:** red tongue, scanty coat
 * Pulse:** fine, rapid or thread, rapid
 * Treatment Principles:** Enrich and supplement the liver and kidneys, subdue yang and quiet the spirit
 * Acupuncture Treatment:**
 * Herbal Treatment:**
 * -** Zuo Gui Wan Jia Jian - [Shu Di (12-15g.), Shan Yao (12g.), Sha Zhu Yu (10g.), Gou Qi Zi (10g.), Gui Ban Jiao (12-15g.)] 1
 * Modifications:**

Spleen-Stomach Vacuity Weakness 1,2 Epileptiform attacks which endures without cure or may return in a short time, lassitude of the spirit, lack of strength or energy, occasional dizziness, torpid intake, bloated abdomen, suffocating sensation on the chest, heavy head or limbs, may be overweight type, cold hands and feet, lusterless facial complexion, loose stools, possible nausea and/or vomiting of white profuse and clear phlegm BL-20, BL-21, CV-12, ST-40, ST-36, LR-13. Even technique1 SP-3, SP-6, SP-9, ST-36, ST-40, PC-6, CV-6, CV-12, GV-202 -Liu Jun Zi Tang - [Dang Shen (10-12g.), Fu Ling (10-12g.), Bai Zhu (10g.), Gan Cao (3g.), Ba Xia (10-12g.), Chen Pi (6-10g.)]1 - [Dang Shen, Ju Hong, Bai Zhu, Fu Ling, Ban Xia, Shi Chang Pu, Yuan Zhi, Yu Jin, Zhi Shi, Bai Fan, Gan Cao] 2 Severe vomiting1: + Zhu Ru, Zhi Ke Phlegm harassing heart spirit w/ restlessness1: +Shi Chang Pu, Yuan Zhi, Tian Nan Xing, Jiang Can Nausea & vomiting1: + PC-6
 * Tongue:** pale tongue, white thick coat
 * Pulse:** soggy, weak
 * Treatment Principles:** Enrich Fortify the spleen and boost the Qi, harmonize the stomach an transform turbidity
 * Acupuncture Treatment:**
 * Herbal Treatment:**
 * Modifications:**

Blood Vessel Stasis & Obstruction 1,2 Sudden onset and patient will fall down (faint), contraction of limbs, Habitual headache which is fixed in place, either pounding or piercing in nature, worse at night. Bluish face or extremities, cyanosis of lips and fingers, can be triggered by anger or strong emotion stimulation, possible history of injury to the head -SP-10, LR-3, LI-4, GB-20, GV-20, Yin Tang. Draining technique1 -Yin Tang, GV-12, GV-20, GB-5, GB-8, GB-15, GB-41, BL-10, BL-172 - [Tao Ren, Hong Hua, Chi Shao, Chuan Xiong, Shi Jue Ming, Mu Li, Quan Xie, Di Long, She Xiang] 2 Severe headache1: + Wu Ling Zhi, Pu Huang Simultaneous Qi vacuity1: + Huang Qi, Dang Shen Simultaneous blood vacuity1: + Dang Gui, Sheng Di
 * Tongue:** purplish tongue w/ static macules on edges of tongue, white coat
 * Pulse:** choppy or small, bowstring
 * Treatment Principles:** Quicken the blood and dispel stasis, open the orifices and extinguish wind
 * Acupuncture Treatment:**
 * Herbal Treatment:**
 * -**Tong Qiao Huo Xue Tang He Zhi Jing San Jia Jian -[Tao Ren (10g.), Hong Hua (3-10g.), Chi Shao (10-15g.), Chuan Xiong (6-12g.), Dan Pi (10-12g.), Yu Jin (10g.), Quan Xie (1-1.5g.), Wu Gong (1-1.5g.)] 1
 * Modifications:**

Heart Blood Deficiency, Shen Losing Nourishment 2 Palpitations, weak body or limbs, insomnia, nightmares, wake up in the early morning or sleep lightly, frequently feels anxious, dreams a lot during sleep, easily startled, may sleep walk, may have low Shen clarity, poor concentration and memory, pale or sallow complexion, Shen weakness, dizziness, vertigo and headache [Suan Zao Ren, Bai Zi Ren, Mai Dong, Sheng Di, Fu Ling, Dan Shen, Yuan Zhi, Wu Wei Zi, Lian Zi Xin, Zhi Gan Cao] 2
 * Tongue:** pale tongue, thin coat
 * Pulse:** weak, deep
 * Acupuncture Treatment:** BL-15, BL-17, BL-20, HT-7, ST-36, SP-10, CV-14, GV-11, GV-20
 * Herbal Treatment:**

Phlegm Obstructing Meridians 2 Frequent and recurrent numbness of limbs, possibly accompanied by tingling and pain, coughing or vomiting phlegm, profuse sputum, dizziness, headache, nausea, feeling of chest pressure or suffocating, heavy head or limbs, heavy abdomen, swelling of the body [Zhu Ru, Chen Pi, Quan Xie, Si Gua Luo, Bai Jie Zi, Qin Jiao, Di Long, Dang Gui, Chuan Xiong, Ban Xia] 2
 * Tongue:** pale and swollen tongue
 * Pulse:** deep, slippery
 * Acupuncture Treatment:** LI-4, LR-3, ST-40, GB-34, SP-6, SP-9, CV-12, Ashi
 * Herbal Treatment:**