Epilepsy is defined as paroxysmal and temporary disturbance of brain characterized by loss of consciousness and muscle tic or abnormal sensation, emotion and behavior. In TCM, this disease is categorized as "xian zheng" (epilepsy syndrome) and "dian xian" (epilepsy).  

Main Points of Diagnosis

1. The histories of family, epileptic attack and encephalopathia should be inquired carefully.

2. Clinical manifestations of the disease vary greatly. There may be grand mal, petit mal, rolandic mal and infantile spasms. The grand mal is characterized by sudden loss of consciousness, general totanic spasm with apnea, cyanosis and foam in the mouth, which usually last for 1¡ª5 minutes. The patients may then fall into sleep and become conscious a few hours later. The petit mal is characterized by sudden, short loss of consciousness without aurae and muscle tic, accompanied with interruptions of speech and action which usually persist for 2¡ª10 seconds. The patient usually comes to consciousness rapidly.

3. Electroencephalogram examination and tomography may be useful for the diagnosis of epilepsy. 

Differentiation and Treatment of Common Syndromes     

1. Epilepsy Induced by Terror

Main Symptoms and Signs: Sudden panic resulting in confusion and loss of self-control, sometimes fright and sometimes alarm and restlessness, crying with fear during sleep, tendency to remain in the mother's arms, alternative flush and pallow on the face, red tongue with white fur, taut and rapid or taut and slippery pulse.

Therapeutic Principle: Tranquilizing the mind and resolving phlegm to arrest epilepsy.

Recipe: Modified Polygala Bolus.

polygala root

codonopsis root

poria

grassleaved sweetflag rhizome

dragon's teeth (To be decocted prior to others)

curcuma root

arisaema with pig's bile

wile jujuba seed

arborvitae seed

cicada slough

lucid asparagus

All the above herbs are to be decocted in water for oral administration.

2. Epilepsy due to Accumulation of Phlegm

Main Symptoms and Signs: Convulsion of extremities during a fit of epilepsy, unconsciousness or vertigo, headache and abdominal pain, accompanied with stridor produced by phlegm in the throat, salivation, yellow face, thick fur of the tongue, and slippery and rapid pulse.

Therapeutic Principle: Removing phlegm and inducing resuscitation.

Recipe: Modified Phlegm-Removing Decoction.

pinellia tuber

tangerine peel

poria

bamboo shavings

bitter orange

gastrodia tuber

arisaema with bile

grassleaved sweetflag rhizome

scorpion

licorice root

All the above herbs are to be decocted in water for oral administration.

3. Epilepsy due to Blood Stasis

Main Symptoms and Signs: With a history of birth injury or trauma often manifested as paroxysmal localized headache, occasional vomiting, paroxysmal convulsion of the whole body or half body or local region upon attack, dark purple tongue with ecchymoses, thready and unsmooth pulse and dark purple superficial venule of the index finger.

Therapeutic Principle: Promoting  blood circulation to remove blood stasis, waking up the patient from unconscious ness and arresting epilepsy.

Recipe: Modified Decoction for Activating Blood Circulation.

ligusticum root

red peony root

peach kernel

safflower

bulb and root of Chinese green onion

fresh ginger

Chinese date

red sage root

musk (Ground into powder to be taken after being infused in the finished decoction)

All the above ingredients except musk are to be decocted in water for oral administration.

In case of deficiency of qi, add 30 grams of astragalus root and 12 grams of codonopsis root into the above mentioned recipe.  

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