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

1.  Xie H and Preast V (eds). Xie’s Veterinary Acupuncture. Ames: Blackwell Publishing, 2007: 263–265

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.