How I Treat Seizures with Acupuncture and Herbal Medicine

WORLD SMALL ANIMAL VETERINARY ASSOCIATION CONGRESS PROCEEDINGS, 2018

I. Introduction
In Traditional Chinese Medicine (TCM), a seizure is called Choufeng and epilepsy is
called Xian Zheng. There are Yin and Yang seizures. Yin seizures are rarely connected
with epilepsy. Yang seizures are clenched and spastic. The earliest literature on seizure
and epilepsy can be found in Su Wen published during the 3rd Century BC. Both seizures
and epilepsy belong to “Internal Wind Syndromes”. The metaphor implies the movements
one sees when wind rattles leaves on trees, causing them to shake erratically and
involuntarily. These motions exhibited by leaves in a strong breeze resemble the people
experiencing seizures. Traditional Chinese Veterinary Medicine (TCVM) shares the
similar philosophy and theory of epilepsy in human TCVM. From the TCVM Medical
perspective, etiologies of internal wind invasion involve six patterns (3 Excess and 3
Deficiency) that can result in seizures in both animals and man. The 3 Excess patterns
include, Obstruction by Wind Phlegm, Internal Profusion of Phlegm Fire, and Blood
Stagnation. The 3 Deficiency patterns are Liver Blood Deficiency, Kidney/Liver Yin
Deficiency, and Kidney Jing Deficiency. Although they can be some overlap and
combination of patterns, generally a patient will have a dominant pattern.
II. General TCVM Treatment For Seizures
1. General Acupoints for Seizures and Its Functions
Extinguish Wind: GB-20, Da-feng-men, CV-15, PC-5
Liver points: BL-18/19, LIV-3
Nourish Blood: BL-17, SP-10
Transform Phlegm: ST-40
Calm the Shen: GV-17/20/21, PC-6, HT-7, An shen, Nao-shu
Special points: GV-1
During seizures: GV-26, Nao-shu, HT-7
2. Basic Chinese Herbs for Seizures
Gastrodia (Tian Ma), Uncaria (Gou Teng), Concha Ostrea (Mu Li), Magarita (Zhen
Zhu), Cornu Antelopis (Ling Yang Jiao), Lumbricus (Di Long), Buthus Martenzi
(Quan Xie), Acorus (Shi Chang Pu), Bombyx (Jiang Can), Cicada (Chan Tui),
Typhonium (Bai Fu Zi)
3. Classic Chinese Herbal Formula for Seizures
Di Tan Tang (aka herbal ‘Phenobarbital’) from Ji Sheng Fang by Yan Yong-He, 1253
It is functioning to transform phlegm, clear Internal Wind and stop seizure
 I usually always start with this formula and then add others if needed. Give 0.5
gram every 10 pounds of body weight, two to three times a day
III. Pattern Differentiation & Treatment
1. Obstruction by Wind Phlegm
Signs: Sudden onset of seizures, loss of conscious, foaming at the mouth, possible
U/D incontinence, depression or change of behavior right before seizures, often due
to vascular event. Tongue is pale or purple with a white greasy. Pulses are wiry and
slippery
Treatment principles: Expel Phlegm, extinguish Wind, open the orifices, calm the
Shen
Acupoints: General acupoint above; add ST40, BL12, ST6 to clear Phlegm and
Wind
Herbal formula: Ding Xian Wan, 0.5 g per 1020 lb body weight BID-TID
2. Internal Profusion of Phlegm Fire
Signs: Sudden onset of seizure without warning, Wood personalities prone, sudden
loss of conscious, foaming at the mouth and sometimes screaming, easily agitated
and irritability, constipation, coughing, insomnia/barking or other abnormal behavior,
clinical signs worse at night, increased panting, cool-seeking. Tongue is red or
purple, with a yellow greasy coating. Pulses are rapid, wiry and slippery
Treatment principles: Clear the Liver, drain fire, transform phlegm, open the orifices
Acupoints: General acupoint above; ST44, LI-4, LI-11, GV-14, Er-jian, Wei-jian to
clear Heat/Fire
Herbal formula: Long Dan Xie Gan Tang + Di Tan Tang, 0.5 g per 1020 lb body
weight of each BID-TID
3. Blood Stagnation
Signs: Usually trauma associated (i.e. history of injuries to the head), sudden onset
of seizure without warning, loss of consciousness, foaming at the mouth and
screaming, loss of continence of bowels and/or urine, temporary disorder of
consciousness with or without seizure. Tongue is pale or purple, often with a white
greasy coating. Pulses are wiry and slippery
Treatment principles: Expel Phlegm, extinguish Wind, and invigorate Blood
Acupoints: General acupoints above; add LI-4, ST-30/36, BL-21 to clear stagnation
Herbal formula: Ding Xian Wan + Tao Hong Si Wu San, 0.5 g per 1020 lb body
weight of each BID-TID
4. Liver Blood Deficiency
Signs: Chronic seizures (epileptics), anemia, weight loss, dry or brittle hair, cracked
nails, muscle rigidity, especially of the neck and jaw, generalized weakness, cool
ears and nose, warm seeking. Tongue is pale and dry. Pulses are weak, deep and
thready
Treatment principles: Nourish Blood, expel Wind and Phlegm
Acupoints: General acupoints above; add: LIV-8, ST- 36, SP-6, CV-12, BL-20, ST44
to support Qi and Blood
Herbal formula: Bu Xue Xi Feng San or Tian Ma Gou Teng Yin, 0.5 g per 1020 lb
body weight BID-TID. Add Di Tan Tang if there is also Phlegm pattern
5. Liver/Kidney Yin Deficiency
Signs: Chronic seizures (epileptics), dry nose and mouth, seizure occurred at late
 afternoon or night, increased panting, coolseeking, nose and body feel warm to the
touch. Tongue is red and dry with thin or no coating. Pulses are deep, fast and
thready
Treatment principles: Nourish Yin, extinguish Wind, harmonize KID and LIV=
Acupoints: General acupoints above; add BL23, KID3/7, SP6/9, LI11, Er-jian to
nourish Yin and clear Heat
Herbal formula: Yang Yin Xi Feng San or Tian Ma Gou Teng Yin, 0.5 g per 1020 lb
body weight BID-TID. Add Di Tan Tang if there is also Phlegm pattern
6. Kidney Jing Deficiency
Signs: Multiple seizures at a very young age (1 year old or younger), often in
combination with other congenital problems, inactive, dry nose and mouth. Tongue
is pale or red but can be normal. Pulses are weak and thready but can be normal.
Treatment principles: Nourish Kidney Jing, expel Wind, strengthen Spleen
Acupoints: General acupoints above; add KID3/7, BL20/23, ST36, SP6, Bai-hui,
GV-4 to support Qi, Yin and Yang
Herbal formula: Epimedium Powder + Di Tan Tang, 0.5 g per 1020 lb body weight of
each BID-TID
IV. Other Considerations
1. General guidelines
a. Acupuncture, once every 2 to 4 weeks for 5–8 sessions initially, then every
3–6 months for maintenance.
b. Herbal formula based on the TCVM pattern/differentiation, 3 to 6 months.
General doge is 0.5 gram per 10 pounds BID-TID. If you don’t know the
patterns, you may always start with Di Tan Tang.
c. If it is a cluster of seizure, or starting a case already on Western medication,
combine use of anticonvulsants: Phenobarbital (2 mg/kg, PO BID) +
potassium bromide (33 mg/kg, PO q24h) with the herbal formulations.
Herbal medicine can be safely taken with these drugs. When the seizures
are controlled (seizures free for 2–3 months with both TCVM treatments
and medications), gradually reduce phenobarbital or KBr to lowest effective
dose.
d. I usually start by reducing one medication by 1/4 and gradually decrease by
1/4 every couple weeks as long as there are no seizures, but I would
continue herbs for about 6 months.
2. Avoid the Yang (warm) proteins (chicken/lamb/venison, etc.).
3. Avoid chemicals and drugs, which could make them more susceptible to
seizures including Heartgard, Program, Advantage or Frontline (may lower the
seizure threshold).
a. Interceptor and Filaribits appears to be safe for dogs with seizures
b. Revolution may be safe to control heartworms
4. Avoid stress and exercise regularly.
V. Scientific Evidence
In neurobiological terms, the metaphors of “eliminating wind in the head” or
“dispersing heat” translate into vagal nerve stimulation and reduction in sympathetic
tone.
 In a rat model study, electroacupuncture at ear-point reduced epileptiform
discharges in the cortex as well as epileptiform behaviors.5 Electroacupuncture
suppressed levels of excitatory neurotransmitters in the hippocampus, whereas
levels of the inhibitory neurotransmitters glycine, taurine, and GABA increased.
Electroacupuncture stimulation in rats with pilocarpine-induced epilepsy improved
cognitive deficits and prevented shrinkage of areas within the limbic system of the
brain.6
Electroacupuncture at either 1 mA or 3 mA significantly inhibit the
pentylenetetrazole-induced cortical epileptiform activities in rats, and higher
stimulation (3 mA) was not associated with a greater inhibition.7
In a preliminary report, exogenously supplemented taurine improves the ability of
electroacupuncture to protect against seizures in rats with penicillin-induced
epilepsy; certain Chinese herbs prescribed for epileptic patients contain high
amounts of taurine.
Summary
TCVM can be an excellent adjuvant to conventional therapy in epileptic animals,
especially those with poorly controlled seizures. In mild cases, or after an initial seizure,
TCVM can be used alone to help prevent and minimize the occurrence of further
seizures.

References
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2. Cheuk DKL and Wong V. Acupuncture for epilepsy. Cochrane Database of Systematic Review. 2006;
Issue 2. Art No.: CD005062 DOI: 10.1002/14651858. CD005062.pub2.
3. Panzer RB and Chrisman CL. An auricular acupuncture treatment for idiopathic canine epilepsy: a
preliminary report. American Journal of Chinese Medicine. 1994;22(1):11–17
4. Cakmak YO. Epilepsy, electroacupuncture and the nucleus of the solitary tract. Acupuncture in Medicine.
2006;24(4):164–168.
5. Van Niekerk J. The use of acupuncture in canine epilepsy. Journal of the South African Veterinary
Association. 1988;59(1):5.
 6. Shu J, Liu R-Y, and Huang X-F. The effects of ear-point stimulation on the contents of somatostatin and
amino acid neurotransmitters in brain of rat with experimental seizure. Acupuncture & Electro-
Therapeutics Res., Int J. 2004;29:43–51.
7. Guilherme dos Santos J, Tabosa A, Hoffmann Martins do Monte F, et al. Electroacupuncture prevents
cognitive deficits in pilocarpine-epileptic rats. Neuroscience Letters. 2005;384:234-238.
8. Zhang JL, Zhang SP, Zhang HQ. Antiepileptic effects of electroacupuncture vs vagus nerve stimulation
on cortical epileptiform activities. J Neurol Sci. 2008 Jul 15;270(1-2):114–21.
9. LiQ, Guo J-C, Jin H-B, et al. Involvement of taurine in penicillin-induced epilepsy and anti-convulsion of
acupuncture: a preliminary report. Acupuncture & Electro-therapeutics Res., Int J. 2005;30:1–14.

SPEAKER INFORMATION
(click the speaker's name to view other papers and abstracts submitted by this speaker)
R. Koh
Veterinary Teaching Hospital
School of Veterinary Medicine
Louisiana State University
Baton Rouge, LA, USA