Epilepsy page 1 1. Epilepsy: A Case Study Comparing Western and
Traditional Chinese Treatment Procedures
2. by Hila Ravid, Shai Ravid and Reuven Ravid
4. Epilepsy is the world’s most common neurological
1disease. Western medicine treats epilepsy primarily
with medication and, infrequently, surgery.
Traditional Chinese medicine uses a combination of
acupuncture and herbal formulas. A case study
describes the successful treatment of a 24-year-old
woman by traditional Chinese medicine (TCM).
6. Epilepsy, Dian Xian, traditional Chinese medicine,
Western medicine, Acupuncture, Phlegm, Wind, Fire,
Yin deficiency, Liver, Spleen, Heart, Kidney.
8. Throughout the centuries, in different cultures,
certain superstitions grew up regarding epilepsy.
The ancient Greeks for example, called epilepsy the
sacred disease, and even in Martin Luther’s time
epilepsy was referred to as a demonic illness. In
the Middle Ages and into the modern era, the common
belief was that devils and ghosts were responsible
for epilepsy. According to the Talmud, one of the
holy books of Judaism, epilepsy was regarded as a
disease of (demonic) possession. It was only at the
thend of the 19 century, when western medicine began
to provide neurological clues as to the disease
process, that the prejudices against epilepsy
gradually begin to recede.
Epilepsy page 2
art One: Epilepsy as understood by Western 9. P
210. Definition of epilepsy
11. Epilepsy is a brain disorder marked by electrical disturbances in brain wave frequency, which results in a seizure.
312. Varieties of epilepsy
13. Seizures are classified as either generalised or partial and may be primary (idiopathic) or secondary. Where the electrical disturbances are spread throughout the entire brain the disease is called general epilepsy; when they are restricted to a particular area of the brain it is called partial or focal epilepsy.
14. Primary (idiopathic) epilepsy
15. In this case the cause of the seizures is unknown and there is no indication of previous brain damage. In about five to ten percent of cases there is a genetic basis. Even an electro encephalogram (EEG) may not provide a clear-cut indication that a
16. There are two major types of idiopathic epilepsy:
517. Tonic-clonic (grand mal)
i. In the tonic phase of the seizure,
breathing stops due to contractions of the
air passages, and in the clonic phase
there are convulsions. The patient may
vomit, and after regaining consciousness
can experience such symptoms as headache,
Epilepsy page 3
muscle pains and a desire to sleep. These
seizures can vary as to frequency and
length. This type of epilepsy usually
begins between the ages of four and 20
years and often ceases naturally as the
patient gets older. Seizures, which begin
after 25 years of age, are generally of
the secondary variety.
618. Absence (petit mal)
a. These seizures are very brief, lasting only
five to ten seconds. During this time the
patient is unresponsive and immobile although
there may be tremors of the eyelids or
shoulders. This particular seizure returns
several times daily, and after the seizure the
patient has no conscious recollection of what
happened. This type of epilepsy usually ceases
719. Secondary epilepsy
20. This type of epilepsy results from damage to the brain cortex and may be due to viral infections, tumours, foreign objects, metabolic disease such as hypoglycaemia, anorexia nervosa, calcium deficiency, genetic diseases, vascular accidents etc. Seizures can appear either days or years after the injury to the brain.
22. Management of the symptoms is aimed at improving the patient’s quality of life by reducing or eliminating seizures. Treatment can be drug based or involve a surgical procedure.
Epilepsy page 4 Antiepileptics/anticonvulsants are generally efficient in treating most seizures, however side effects and toxicity can be a problem. Surgical procedures can be used for the prevention of seizures but this is only undertaken where the patient has not responded to conventional treatment and is considered to be at high risk.
923. Drug Treatment
24. Name of 25. Type 26. Us27. Opti28. Selected
drug of ual mal side effects
seizures adult (Therapeut
daily ic) level
dose of drug in
(mg/kg) the blood
29. Phenytoin 30. Toni31. 4-32. 10-33. Nystagmu
c-clonic, 8 20 s, ataxia,
34. Carbamazep35. Toni36. 5-37. 4-8 38. Nystagmu
ine c-clonic, 25 s, dysarthria,
39. Valproic 40. Toni41. 1042. 50-43. Nausea,
acid c-clonic, -60 100 vomiting,
44. Phenobarbi45. Toni46. 2-47. 10-48. Drowsine
tal c-clonic, 5 40 ss, nystagmus,
focal ataxia, skin
Epilepsy page 5
etc. 49. Primidone 50. Toni51. 5-52. 5-15 53. Sedation
c-clonic, 20 , nystagmus,
nausea, etc. 54. Ethosuximi55. abse56. 2057. 40-58. Nausea,
de nce -35 100 vomiting,
lethargy, etc. 59. Clonazepam 60. abse61. 0.62. 20-63. Drowsine
nce 05-0.2 80 ss, ataxia,
1064. Surgical Treatment
65. Surgery can involve partial removal of the
temporal lobe or implantation of electrodes in the
brain after the corpus callosum has been separated.
67. The cause of epilepsy is unknown and not every
patient can become seizure free with Western medical
treatment. Many patients suffer additional problems
due to the side effects of their medication.
68. Part Two: epilepsy as understood by Chinese
69. Epilepsy, known as Dian Xian, was identified in
the Chinese medicine classics over 2000 years ago.
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1270. According to Xin-ming epilepsy is due to a
disruption of the Heart, Liver, Kidney and Spleen
energy, with loss of consciousness due to blocking
of the Heart orifices by internal phlegm.
71. Management of epilepsy is holistic; it not only
aims to mitigate the acute disorder but also
addresses the chronic underlying weakness.
72. Chinese Medicine classifies Epilepsy according to shi & xu patterns,
rather than tonic-clonic or absences, in which the most important
causative factor of its appearance is Phlegm in the upper part of the
body (the Upper Jiao) which causes the disturbance of mind and
manifests as the epileptic seizure.
1373. Aetiology and pathogenesis
a. The major aetiological factors are:
74. Liver wind and turbid phlegm obstructing the
75. Liver fire with phlegm heat.
76. Liver and Kidney yin deficiency.
77. 4. Spleen and Stomach deficiency
78. Differential diagnosis and treatment according
14 to patterns
79. Liver wind and turbid phlegm obstructing the
80. Clinical manifestations
81. Before the seizure: dizziness, vertigo,
stiffness of the neck, oppression in the chest,
Epilepsy page 7
82. During the seizure: sudden collapse, locked jaw,
upward staring eyes, convulsions, salivation,
shouting, crying, loss of consciousness without
convulsions, loose stool and urine. The tongue will
have a thin (white or yellow) sticky coating and the
pulse will be either rapid (shu) and slippery (hua)
or tight (jin) and slippery.
84. Liver wind stirs up internal phlegm causing it
to rise upward and mist the Heart and mind. If this
results in convulsions then Liver wind is
predominant; if there is a loss of consciousness
without convulsions, phlegm predominates over Liver
85. Treatment principle
86. Extinguish wind and resolve phlegm, unblock the
Heart orifices and strengthen the Spleen.
87. Main acupuncture points
88. Baihui DU-20, Renzhong DU-26, Jianshi P-5,
Taichong LIV-3, Fengchi GB-20, Fenglong ST-40, Yaoqi
(M-BW-29- an extra point located under the S2 spine.
Needling Method: Insert the needle slanted upwards
2-2 1/2 Cun). Use reducing method and treat daily.
Retain needles for 40 minutes to one hour.
89. Main herbal formula
90. Ding Xian Wan (Arrest Seizure Pill).
91. Liver fire with phlegm heat
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92. Clinical manifestations
93. Epileptic seizure, Irritability, restlessness,
insomnia, bitter taste in the mouth, thirst,
difficult expectoration of yellow phlegm. The tongue
will be red with a yellow coating and the pulse will
be wiry (xian), rapid (shu) and slippery (hua). 94. Pathology
95. Heat from Liver fire condenses body fluids into
phlegm which then causes the phlegm to rise and
block the Heart orifices.
96. Treatment principle
97. Purge Liver fire, resolve phlegm, unblock the
98. Main acupuncture points
99. Renzhong DU-26, Laogong P-8, Xingjian LIV-2,
Benshen GB-13, Fenglong ST-40, Shenmen HE-7,
Yongquan KID-1. Use reducing method and treat daily.
Retain needles for 40 minutes to one hour.
100. Main herbal formulas
101. Long Dan Xie Gan Tang (Drain the Liver
Decoction) or Di Tan Tang (Scour Phlegm Decoction).
102. 3. Liver and Kidney yin deficiency
103. Clinical manifestations
104. Mild seizures, insomnia, poor memory, pain and
weakness of the lower back and knees, dizziness,
constipation, vertigo. The tongue will be red with
scanty coating or without coating and the pulse will
be rapid (shu) and fine (xi).
Epilepsy page 9 105. Pathology
106. Liver and Kidney yin and jing deficiency lead
both to both Liver yang rising and to malnourishment
of the mind. Liver yang rising will further harass
the mind and lead to an epileptic seizure*.
107. Treatment principle
108. Nourish Liver and Kidney yin, subdue Liver yang
and calm the mind.
Main acupuncture points 109.
110. Baihui DU-20, Ganshu BL-18, Shenshu BL-23,
Jinsuo DU-8, Tongli HE-5, Yanglingquan GB-34, Jiuwei
REN-15, Taixi KID-3, Sanyinjiao SP-6, Yaoqi (M-BW-
29). Use even method and treat daily. Retain needles
for 30 minutes.
111. Main herbal formulas
112. Zuo Gui Wan (Restore The Left (Kidney) Pill) or
Tian Ma Gou Teng Yin (Gastrodia And Uncaria
113. 4. Spleen and Stomach deficiency
114. Clinical manifestations
115. Prolonged Epilepsy accompanied by Lassitude,
poor memory, low appetite, nausea, yellow and
lustreless complexion, loose stools, fatigue, thin
body to the point of fragility, vertigo and
dizziness. The tongue will be pale and the pulse
will be soft (ruan) and fine (xi) or soft and weak
Epilepsy page 10 116. Pathology
117. Qi and blood production are reduced due to
weakness of the Spleen and Stomach. Spleen
deficiency leads to the production of phlegm. The
mind is not nourished as the clear qi is unable to
rise due to phlegm accumulation and lack of qi and
Treatment principle 118.
119. Strengthen the Spleen, harmonise the Stomach,
resolve phlegm and increase qi production in order
to nourish Heart blood.
120. Main acupuncture points
121. Baihui DU-20, Xinshu BL-15, Juque REN-14,
Zhongwan REN-12, Zusanli ST-36, Qihai REN-6, Daling
P-7, Fenglong ST-40, Taichong LIV-3, Pishu BL-20.
Use even or reinforcing method. Treat daily or every
other day. Retain needles for 30 minutes.
122. Main herbal formula
123. Liu Jun Zi Tang (Six Gentleman Decoction).
124. Case study
125. The patient was a 24-year-old female with a
history of epileptic seizures from the age of 13.
126. Main clinical manifestations
127. The epileptic seizures were of the tonic-clonic
type and included the following symptoms: blurred
vision that led to dizziness, shouting, collapse and
loss of consciousness, convulsions, salivation and
incontinence of urine. The seizures lasted from one