Convulsions During Pregnancy

CHAPTER 36 Convulsions During Pregnancy



AETIOLOGY 513

PATHOLOGY 513

IDENTIFICATION OF PATTERNS AND TREATMENT 513
Liver-Wind agitating within 513

Phlegm-Fire harassing upwards 515

Empty-Wind 516

PROGNOSIS AND PREVENTION 517

WESTERN VIEW 517

This condition is called zi xian which means ‘convulsions in pregnancy’: it clearly corresponds to eclampsia in Western medicine. It is a condition that occurs not only in pregnancy but also soon after childbirth. The main manifestations are severe dizziness, headache, vomiting, hypertension and, in its late stages, tremors of limbs, convulsions and coma.



Aetiology




Overwork


Overwork injures Liver- and Kidney-Yin; when the Yin of these two organs is deficient, Liver-Yang may rise and Liver-Wind may develop from this. Liver-Wind causes severe dizziness, headache, hypertension, convulsions and coma.



Irregular diet, emotional problems


An excessive consumption of dairy or greasy foods injures the Spleen and leads to Phlegm. Phlegm may obstruct the Mind’s orifices and cause coma. Emotional problems often lead to Qi stagnation and stagnant Qi often turns into Fire after some time. Fire easily combines with Phlegm and may also lead to the development of internal Wind.



Pathology


The pathology of ‘convulsions in pregnancy’ is first and foremost one of internal Wind typically causing severe dizziness, tremors and convulsions. Phlegm is often associated with it and causes unconsciousness by obstructing the Mind’s orifices. Underlying these two excess conditions, there will be a deficiency of Liver- and Kidney-Yin which leads to Liver-Wind, and a deficiency of the Spleen which leads to the formation of Phlegm.



Identification of patterns and treatment


The patterns discussed are:


• Liver-Wind agitating within

• Phlegm-Fire harassing upwards

• Empty-Wind.


Liver-Wind agitating within



Clinical manifestations


Hypertension late in the pregnancy, headache, malar flush, a feeling of heat in the afternoon, tremor of limbs, convulsions, unconsciousness. Tongue: Red and peeled. Pulse: Rapid, Wiry.


This pattern is characterized by Liver-Wind arising out of a background of Liver- and Kidney-Yin deficiency. Often, it is combined with some Phlegm: this is especially evident if the patient falls into unconsciousness.



Treatment principle


Extinguish Liver-Wind, nourish Liver- and Kidney-Yin.



Acupuncture


LIV-3 Taichong, G.B.-20 Fengchi, BL-62 Shenmai (on the right) and S.I.-3 Houxi (on the left), Du-16 Fengfu, Du-26 Renzhong, LIV-8 Ququan, KI-6 Zhaohai, KI-3 Taixi, BL-17 Geshu. BL-17, LIV-8, KI-6 and KI-3 with reinforcing method; the others with reducing method.




Explanation


– LIV-3, G.B.-20 and Du-16 extinguish internal Wind.

– BL-62 and S.I.-3 regulate the Yang Stepping Vessel and extinguish internal Wind. The Yang Stepping Vessel absorbs excesses of Yang which are there in the form of Wind, even though the Wind arises from Yin deficiency. The Yang Stepping Vessel is particularly indicated if both Front pulse positions are Wiry and Full.

– Du-26 extinguishes Wind and promotes resuscitation.

– LIV-8, KI-6 and KI-3 nourish Liver and Kidneys.

– BL-17, with reinforcing method or direct moxa, nourishes Blood.


Herbal treatment



a. Prescription



– LING JIAO GOU TENG TANG

– Cornu Antelopis-Uncaria Decoction


Explanation


– Ling Jiao, Gou Teng, Sang Ye and Ju Hua extinguish Liver-Wind and stop convulsions.

– Bai Shao and Sheng Di Huang nourish Liver- and Kidney-Yin.

– Fu Shen calms the Mind.

– Chuan Bei Mu and Zhu Ru resolve Phlegm. As mentioned above, there is often some Phlegm combined with Wind in this pattern. It is the Phlegm that causes the patient to become unconscious.

– Gan Cao harmonizes.


Modifications


• If there is a headache and dizziness, add Tian Ma Rhizoma Gastrodiae, Bai Ji Li Fructus Tribuli and Shi Jue Ming Concha Haliotidis.

• If there is oedema, add Zhu Ling Polyporus and Ze Xie Rhizoma Alismatis.

• If there are digestive symptoms from Wood overacting on Earth, add Bai Zhu Rhizoma Atractylodis macrocephalae and Shan Zha Fructus Crataegi.

• If there is a bitter taste, mental restlessness and dry throat, add Huang Qin Radix Scutellariae.

• If there are symptoms of Kidney-Yang deficiency and backache, add Tu Si Zi Semen Cuscutae, Sang Ji Sheng Herba Taxilli and Du Zhong Cortex Eucommiae.


b. Prescription



– DI SHEN ZI YIN FANG1

– Rehmannia-Glehnia Nourishing Yin Formula


Explanation

This formula is for high blood pressure from Kidney- and Liver-Yin deficiency and Liver-Wind.


– Sheng Di Huang, Bei Sha Shen, Gou Qi Zi and Mai Men Dong nourish Kidney-Yin.

– Chuan Lian Zi moves Liver-Qi.

– Sang Ji Shen and Bai Shao nourish Blood and pacify the Liver.

– Dan Shen invigorates Blood.

– Shi Jue Ming extinguishes Liver-Wind and subdues Liver-Yang.

Compared with the previous formula, this formula has a stronger Yin-nourishing action and it does not resolve Phlegm.



Summary



Liver-Wind agitating within


Clinical manifestations

Related posts:

  1. Collapse after Childbirth
  2. Prolapse of the Uterus
  3. Acupuncture and Herbal Treatment in Midwifery
  4. Endometriosis

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Jun 6, 2016 | Posted by in GYNECOLOGY | Comments Off on Convulsions During Pregnancy

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