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WSV18-0288
INTEGRATIVE MEDICINE (LECTURES GIVEN IN MANDARIN CHINESE)
IMPROVE SEIZURE CONTROL WITH INTEGRATIVE MEDICINE
R. Koh1
1Veterinary Teaching Hospital, Louisiana State University School of Veterinary Medicine, Baton Rouge, USA
2Veterinary Medical Center, University of Florida College of Veterinary Medicine, Gainesville, USA
Introduction
Integrative Medicine (IM) has become one of the most frequently requested medicine to be used by itself
or in conjunction with conventional medicine or other treatments to treat a variety of challenging illnesses, including pain, seizures, Cushing’s disease, skin problems, and cancer. Practitioners of IM use many different modalities, including acupuncture, Chinese herbal medicine, supplements, massage, and dietary therapy to treat or prevent health problems, improve outcomes, and enhance quality of life.1
Seizure disorder or epilepsy is one of the most challenging neurological conditions affecting pets
and represents a significant number of referrals to veterinary neurologists. It is estimated that 1% of the canine population has some form of seizure disorder.2 The incidence of idiopathic (inherited) epilepsy in certain breeds of dog can be as high as 15% to 20%.2
To date, there is no cure nor ideal treatment for epilepsy. While antiepileptic drugs (AEDs), such as diazepam, midazolam, phenobarbital and potassium bromide
(KBr), can be very helpful in the control of seizure
activity, they reduce the clinical signs but do not treat
the cause2, and not all treatments provide absolute control. Approximately 20% to 40% of epileptic dogs may become refractory to phenobarbital and KBr.3 In addition, some animals are less tolerant of their side effects,
which include lethargy, polyuria/polydipsia, polyphagia, vomiting, sedation, and weight gain (phenobarbital).4 Although these newer drugs, such as levetiracetam, zonisamide, felbamate, topiramate, gabapentin, and pregabalin, have gained considerable popularity in the management of epilepsy, scientific data on their safety and efficacy are very limited and cost is often prohibitive.
Traditional Chinese Veterinary Medicine (TCVM)
Regardless of the causes of epilepsy, TCVM is an effective treatment to help complement current medications and improve seizure management. Indications for TCVM therapies include side effects caused by AEDs, refractory seizures, and quality of life of the patient.
· A number of published studies demonstrate
the anti-epileptic effects of acupuncture as
an adjunctive treatment for seizures in animal models and humans.5-13 Different modalities of acupuncture have been used to treat seizures, including needle insertion,5,10 electrostimulation,14 scalp acupuncture,12 auricular acupuncture,6,7,15, and gold bead/wire implants on acupuncture points.8,11 Accumulating data have showed that acupuncture may have an effect on epilepsy by increasing the release of inhibitory neurotrans- mitters, such as serotonin, GABA, nitric oxide, or opioid peptides.15
· Herbal medicine is another major component of TCVM and has been advocated as an adjunctive therapy in seizure control, usually in conjunction with acupuncture.16 TCVM practitioners usually prescribe combinations of herbal medicines. The most frequently used Chinese herbal medicine in the management of seizures is Di Tan Tang (Chinese herbal equivalent of phenobarbital). The author uses 0.5g per 10-20 pounds q12h. It contains Uncaria, Arisaemi, Acorus, Poria and Glycyrrhiza, which have been shown to possess anti-epileptic activity in animal models.17 Nux vomica, Illicium henryi, betelnut and mulberry are only a few herbals that should be avoided as they have been found to induce seizures.18
· Form the TCVM standpoint, pattern differenti- ation (Diagnosis) is important for the treatment strategy for seizures. Selections of acupoints and herbal formulas are based on the pattern differentiation of the patient.
The TCVM philosophy of seizures
The philosophy of disease treatment in TCVM differs from that of Western medicine. TCVM treats the individual, not the disease. From the TCVM standpoint, seizure is caused by “internal Wind” invading the channels of Liver due to Heat generated by the Liver (known as Liver Yang rising). The metaphor of “Wind” implies the shaking of tree leaves in a strong breeze, which resembles seizure activity. The Heart and Kidneys are also involved in seizures. The Kidney, in TCVM, is Water. Water nourishes Wood (Liver) and hinders Fire (Heart), so if the Kidneys are out of balance, it could influence the Liver or Heart imbalances that trigger seizures.
TCVM treatment for seizures involves calming the Liver, eliminating Wind, calming the Mind, clearing Phlegm,
and restoring consciousness (see table).1 It is also important to balance the Qi, Blood, Yin and Yang if they are involved. Acupuncture can be given once every two to four weeks for five to eight sessions initially, along with Chinese herbal medicine. After that, the treatments can be spaced out to once every three to six months
for maintenance. Once the seizures are under control, you can gradually reduce the dosage of phenobarbital, potassium bromide, or other AEDs to the lowest effective dose (one at a time). Gold bead or wire implant can be
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