Infantile Convulsion

Infantile convulsion is commonly seen in pediatrics , manifested by series of muscle contractions accompanied by impairment of consciousness .

It can be brought about by various causes , including invasion of seasonal pathogenic factors , accumulation of internal phlegm - heat , protracted vomiting and diarrhea , deficiency condition of the spleen with hyper function of the liver . It occurs in any season , mostly in those aged from one to five . Since the onset may be either sudden or gradual and the symptoms may show a deficiency condition or an excess condition , infantile convulsion can be classified into two types : acute and chronic .

Etiology and Pathogenesis

a ) Acute infantile convulsion :

i ) Invasion of seasonal pathogenic factors : The skin and muscles of infants are frail , hence they are easily attacked by external pathogenic wind , which turns into fire in the interior . Infants always have excess activity of the liver , the heat therefore is liable to stir up liver wind , thus wind and fire bring about the impairment of consciousness and convulsion . The exogenous pathogenic heat can also penetrate deep into the pericardium , or the body fluid is consumed by heat and turned into phlegm which blocks the mind , resulting in loss of consciousness and convulsion .

ii ) Accumulation of phlegm fire : Irregular food intake leads to stagnation in the stomach and intestines , obstructing the flow of qi and producing phlegm heat which turns into wind , hence the disease . iii ) Sudden fright : Infants have weak mind with insufficient vital qi . Sudden seeing of strange things and hearing of strange sounds may disturb their qi and blood and stir their mind , causing convulsion .

b ) Chronic infantile convulsion : Its onset is gradual . In most cases it is associated with a deficiency condition , such as persistent dysentery , severe vomiting and diarrhea , or excessive administration of purgatives cold or cool in nature that injures the spleen and stomach , damaging the source of essential nutrients , and leading to deficiency of blood which fails to nourish the liver . As a result , the wind caused by . the condition of deficiency is stirred up internally , giving rise to convulsion . In addition , the chronic infantile convulsion can also be the result of the acute cases that have not been treated properly .

Differentiation

a ) Acute infantile convulsion : Main manifestations : Unconsciousness , upward gazing , lockjaw , neck rigidity , opisthotonos , contracture of limbs , rapid and string - taut pulse .

If fever , headache , cough , congested throat , thirst , and irritability are present , the convulsion is due to the invasion of exogenous pathogenic heat .

If fever , anorexia , vomiting , abdominal distention and pain , sputum gurgling in the throat , constipation or defecation with stinking smell are present , it is due to phlegm heat .

If there is no fever , but cold limbs , disturbed sleep or lethargy , crying and fearing after waking , and intermittent contraction of muscles , the convulsion is probably caused by sudden fright .

Analysis : Invasion of pathogenic heat can be transmitted internally to the pericardium , so the fever is accompanied with irritability or impaired consciousness . Since there is constitutional excess of liver in infancy , the pathogenic heat can induce the liver wind . With the help of the fire the liver wind stirs upwards , resulting in upward gazing , lockjaw , and neck rigidity . Accumulation of phlegm heat and turbid dampness in the stomach and intestines obstructs the circulation of qi , thus causing anorexia , vomiting , abdominal distention and pain , and constipation . Fright harms the mind , hence there is crying with fear .

b ) Chronic infantile convulsion : Main manifestations : Emaciation , pale complexion , lassitude , lethargy with eyes open , intermittent convulsion , cold limbs , loose stool containing undigested food , clear and profuse urination , deep and weak pulse .

Analysis : Chronic illness damages the spleen and stomach , causing disorders in digestion and transportation , thus there are emaciation , pallor and lassitude . Insufficiency of the source of essential nutrients gives rise to the deficiency of yin and blood , so that the liver fails to be nourished , and consequently the wind caused by the condition of deficiency is stirring . Therefore , the victim has lethargic sleep with open eyes and intermittent convulsion . The kidney is also involved in a long - standing case . Yang deficiency of the kidney and spleen is manifested by loose stools with undigested food , profuse and clear urination , cold limbs and deep forceless pulse .

Treatment

a ) Acute infantile convulsion : Method : Points of the Du Meridian and the Liver Meridian of Foot Jueyin . are selected as the principal points . The reducing method is applied to promote the restoration of consciousness , eliminate heat and suppress wind .

Prescription : Yintang ( Extra ) , Shuigou ( Du 26 ) , Taichong ( Liv 3 ) . Supplementary points : Invasion of pathogenic heat : Dazhui ( Du14 ) , Quchi ( Li11 ) , Twelve Jing - ( Well ) Points ( Li1 , L11 , H 9 , Si1 , P9 , SJ 1 ) .

Convulsion due to phlegm heat : Qimai ( S J 18 ) , Zhongwan ( Ren 12 ) , Hegu ( L 1 4 ) , Fenglong ( S 40 ) .

Convulsion due to fright : Sishencong ( Extra ) , Laogong ( P 8 ) , Yongquan ( K 1 ) .

Explanation : Yintang ( Extra ) has a sedative action , while Shuigou ( Du 26 ) can regulate the Du Meridian and promote resuscitation . Puncturing Taichong ( Liv 3 ) with reducing method is to subdue the liver wind . An excess of pathogenic heat can be brought down by puncturing Dazhui ( Du 14 ) and Quchi ( LI II ) . The application of Twelve Jing - ( Well ) Points can eliminate the heat from all the meridians . For those with excessive phlegm heat , Zhongwan ( Ren 12 ) , Fenglong ( S 40 ) and Hegu ( LI 4 ) are used to regulate the spleen and stomach for removing the phlegm heat . Combination with Qimai ( S J 18 ) clears away the heat from the Sanjiao Meridian to relieve convulsion . Sishencong ( Extra ) has the action of tranquilization for those suffering from fright . The supplementary points , Laogong ( P 8 ) and Yongquan ( K 1 ) , are used to calm down the mind and stop convulsion .

b ) Chronic infantile convulsion : Method : Points of Ren and Du Meridians are selected as the principal points . The reinforcing method and moxibustion are applied to adjust yin and yang for sedation and relief of convulsion .

Prescription : Baihui ( Du 20 ) , Shenting ( Du 24 ) , Guanyuan ( Ren 4 ) , Sanyinjiao ( Sp 6 ) , Zusanli ( S 36 ) . Supplementary points : Yang deficiency of the spleen and kidney : Pishu ( B 20 ) , Shenshu ( B 23 ) , Zhongwan ( Ren 12 ) .

Deficiency of blood : Taichong ( Liv 3 ) , Rangu ( K 2 ) .

Explanation : Since chronic infantile convulsion is due to the condition of deficiency , Baihui ( Du 20 ) and Shenting ( Du 24 ) are used for tranquilization , and Guanyuan ( Ren 4 ) . Sanyinjiao ( Sp 6 ) and Zusanii ( S 36 ) to reinforce body resistance and alleviate convulsion . Application of Pishu ( B 20 ) and Zhongwan ( Ren 12 ) builds up the spleen and stomach and strengthens the source of essential nutrients . Shenshu ( B 23 ) is combined with the above points to reinforce the kidney and invigorate the yang in order to dispel the cold . Taichong ( Liv 3 ) and Rangu ( K 2 ) nourish yin and blood to subdue the wind and stop convulsions .

Remarks

a ) Acute infantile convulsion is involved in the infections of the central nervous system and toxic encephalopathies , e . g . epidemic cerebrospinal meningitis and pneumonia with toxemia . Acupuncture has a certain antipyretic and antispasmotic effect . However , it is necessary to make the diagnosis timely and adopt a comprehensive treatment .

b ) Chronic infantile convulsion is mostly caused by long duration of vomiting and diarrhea , metabolic disorders , malnutrition and chronic infections of the central nervous system , or transmitted from acute , convulsion . So the comprehensive treatment should also be adopted .