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EPILEPSY

NESA Int Med EPILEPSY

QuestionAnswer
Describe the symptoms of mild epilepsy. Suddenly stopping activities, staring, blinking or rolling up the eyes; unawareness during a blank interval; generally no falling down; dropping what is being held; sudden bending and lifting of the head; slight jerking movement of the head or arms.
Describe the symptoms of severe epilepsy. Sudden crying out (bleating); falling to the ground; loss of consciousness; eyes roll up; foaming at the mouth; body becomes stiff and twitches or there is uncontrollable, spasmodic jerking of the limbs. Possible incontinence of urine and bowel.
Describe the epileptic aura. Warning of an impending seizure occuring just before or up to several hours before a seizure. Sense of tension, vague feeling, distinctive odor, distorted vision, bodily sensation (particularly in the stomach), dizziness, a stifling sensation in the chest
What are the five causes of epilepsy according to TCM? Mental and emotional factors; constitutional hereditary factors; traumatic injury; improper diet; others
Elaborate on the mental and emotional factors leading to epilepsy. Excessive emotional and mental states cause epilepsy, particularly fear, anxiety or sudden shock or fright by disturbing the normal movement of qi and injuring the viscera and bowels.
Elaborate on the constitutional and hereditary factors leading to epilepsy. Severe fright or shock to the mother during pregnancy impairing the fetus leads to epilepsy.
How does traumatic injury lead to epilepsy? Brain damage at birth (birth trauma or forceps delivery) or a severe head injury causes qi stagnation and blood stasis.
How does improper diet cause epilepsy? It is an indirect cause, however impairment of the Spleen and Stomach disturbs the transportation and transformation of nutrients causing an accumulation of turbid phlegm.
What are the other factors that cause epilepsy? Stroke, brain infection, brain tumor, brain surgery, infarction, sleep deprivation, physical exhaustion, drug or alcohol use, fever, flickering lights, etc.
List the crucial points in diagnosing epilepsy. Know the history of the disease and the manifestations; identify the severity of the disease; distinguish between xu and shi patterns; identify the types of abnormal qi mechanism in order to add herbs that move qi in the correct direction.
What is the general treatment strategy during periods of frequent seizures? Treat the manifestations: expel phlegm, extinguish wind, open the orifices, regulate the flow of qi.
What is the general treatment strategy between seizure episodes? Treat the roots: strengthen the Spleen, transform phlegm, invigorate the blood, tonify the Liver and Kidney, nourish the Heart, calm the spirit.
What are the two phases of epilepsy? Attacking and remitting
What are the two types of seizures that occur during the attacking phase? Yang seizures and Yin seizures
What are the manifestations of Yang seizures? Grand mal seizure, prodromal s/s, aura, severe symptoms, greasy white or yellow tongue coat, wiry-rapid or wiry-slippery pulse
What are the treatment principle and formula for Yang seizures? Open the orifices, restore consciousness, clear heat, transform phlegm and extinguish wind with Ding Xian Wan (Arrest Seizures Pill)
What are the manifestations of Yin seizures? Petit mal seizure, s/s of mild epilepsy, pale tongue with thick, greasy, white coat, deep-thin or deep-slow pulse
What are the treatment principle and formula for Yin seizures? Open the orifices, restore consciousness, warm the yang and transform phlegm with Wu Sheng Yin (Five Unprepared Ingredients Decocotion)
What are the five patterns the comprise the remitting phase of epilepsy? Obstruction by wind-phlegm; Liver fire with internal profusion of phlegm-fire; Vacuity of Spleen and Stomach qi; Vacuity of Liver and Kidney yin; Blood stasis
What are the treatment principle and formula for Obstruction by wind-phlegm? Expel phlegm, extinguish wind, open the orifices and stabilize epilepsy with Ding Xian Wan (Arrest Seizures Pill)
What are the treatment principle and formula for Liver fire with internal profusion of phlegm-fire? Clear the Liver, drain fire, transform phlegm and open the orifices with Long Dan Xie Gan Tang plus Di Tan Tang (Scour Phlegm Decoction) or Dang Gui Long Hui Wan
What are the treatment principle and formula for Vacuity of Spleen and Stomach qi? Strengthen Spleen qi and transform turbid phlegm with Liu Jun Zi Tang
What are the treatment principle and formula for Vacuity of Liver and Kidney yin? Nourish and tonify the Liver and Kidney with Da Bu Yuan Jian (Great Tonify the Basal Decoction) or Zuo Gui Wan
What are the treatment principle and formula for Blood stasis? Invigorate the blood, dispel blood stasis and regulate qi with Xue Fu Zhu Yu Tang (Drive Out Stasis in the Mansion of Blood Decoction) or Tong Qiao Huo Xue Tang (Unblock the Orifices and Invigorate the Blood Decoction)
Which herbs can be added to remitting phase formulas if the case is severe? 1-1.5 g of Quan Xie Fen and Wu Gong Fen
Created by: rswain