dylannb: May 11, 2021, 3:04am
Several weeks ago I treated an 11 year old girl for seizures. She has a history of having a grand mal seizure twice
each year. Her last one was 1 month before I saw her a few weeks ago. Her mom has been a patient of mine and
she wanted to have her try out acupuncture.
I supplemented LV on the Right for these reasons:
Eyes sparkling, polite, cheeks slightly reddish. Her mom said she has a tendency to be hard on herself.
Treatment seemed to go well.
A few weeks later I saw her mom in clinic (I had been out of town for a couple of weeks). She said that her
daughter felt really good that day of treatment, slept really well and even talked about coming back again for
treatment sometime. She had 3 really pleasant days. Then 5-6 days after the treatment she had a series of seizures
6 in a couple day period! She has never had multiple like this before.
Mom is willing to bring her back in. I am questioning if this was the completely wrong treatment and next time I
should Supplement San Jiao (though I m not leaning this way).
Other than the seizures she appears pretty healthy with the following being the only real standouts for me at the
time.
Thin (skin not remarkably dry or damp), symmetrical.
Tendency to get hot at night and sometimes has night sweats.
Even though LV is Wood and Jueyin double wind I wasn t thinking of this as potentially exacerbating seizures.
My Sa am perspective of LV is more about the shielding, inward movement and supplementing blood. I m
thinking of a cool, inward breeze to counterbalance the outward moving and warm San Jiao. I d love to hear an
experienced perspective of the LV and wind component
Other thoughts for treatment:
Sup PC. Her mom mentioned her sleeping better the few days following treatment, so deducing that she wasn t
sleeping wonderfully before, plus the nightsweats may be GB doing too much up and out.
Sup UB. Slight reddish color on cheeks, getting hot (and sometimes) sweaty at night. Perhaps seizures can be seen
as hyperactivity.
How about Sup SI? I know Toby likes to Sup SI for windy natured things, but hearing him talk about a couple
seizure case studies, I don t remember him choosing Sup SI for those. And not sure about adding dynamic
movement to such a dynamic manifestation
George_Mandler: May 12, 2021, 2:47pm
04/01/2024, 12:17Sa’am for seizures gone awry? – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/saam-for-seizures-gone-awry/1563/print2/7
Thank you for the case Dylan.
dylannb:
She had 3 really pleasant days. Then 5-6 days after the treatment she had a series of seizures 6 in a couple day
period! She has never had multiple like this before.
A negative reaction 5 days later I don t think we would expect to be an adverse reaction. But it leaves me with
more questions.
What was different in those 3 pleasant days after the treatment than before the session besides her sleep?
Those were grand mal as she had 1 month prior?
Did it stop after the 2 days and has she had one since? If she had another one then it seems frequency did increase
and I would consider if doing a 1x SJ+ on left even though it is a week or more later.
dylannb:
I supplemented LV on the Right for these reasons:
Eyes sparkling, polite, cheeks slightly reddish. Her mom said she has a tendency to be hard on herself.
Is there anything about her that shows some Liver excess?
How would you characterize the wind during the seizure. Is she locked up or more outward? Grand mal I believe
are locked up – I would see that as a Liver excess.
dylannb:
Tendency to get hot at night and sometimes has night sweats.
thinking BL+ could be a safe bet.
dylannb:
I d love to hear an experienced perspective of the LV and wind component
In Sa am the Liver is thought of as an inward wind – deep inward to self. Whereas the GB is more of an outward
wind in movement aggression paired with an inward more intelligent wind of the PC. This could be an inward
wind during the seizure even though she appears to have more SJ excess signs.
How does she dress?
dylannb:
plus the nightsweats may be GB doing too much up and out
possible, but as you said in your next sentence I d be thinking HT excess.
dylannb:04/01/2024, 12:17Sa’am for seizures gone awry? – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/saam-for-seizures-gone-awry/1563/print3/7
Sup UB. Slight reddish color on cheeks, getting hot (and sometimes) sweaty at night. Perhaps seizures can be
seen as hyperactivity.
This seems like a safe channel to choose, although not sure what kind of results.
dylannb:
How about Sup SI? I know Toby likes to Sup SI for windy natured things, but hearing him talk about a couple
seizure case studies, I don t remember him choosing Sup SI for those. And not sure about adding dynamic
movement to such a dynamic manifestation
She is young so it is an option, but it is also dynamic movement. She is 11 so I assume has not hit menarche yet to
check for period discomfort. Unless you see other KD excess signs besides being young SI+ seems risky.
The LR/SJ, HT/BL. even PC/GB dynamic seem like the spokes on the wheel to look more deeply into.
dylannb: May 13, 2021, 5:46pm
Thanks for the reply, George. The result of this case was quite confusing and unsettling for me. I m grateful to have
some discussion.
George_Mandler:
A negative reaction 5 days later I don t think we would expect to be an adverse reaction.
Thanks for clarifying this.
George_Mandler:
What was different in those 3 pleasant days after the treatment than before the session besides her sleep?
I haven t talked to the girl yet, but her mom said that she slept really well, and talked about feeling relaxed and
good, and happily announced on her own that she would come back for more treatment if necessary. I know it s not
much to go off of, but I find this common that people express feeling good after Tx without being able to articulate
why. I don t really know how much weight this kind of reaction deserves
George_Mandler:
Is there anything about her that shows some Liver excess?
How would you characterize the wind during the seizure. Is she locked up or more outward? Grand mal I
believe are locked up – I would see that as a Liver excess.04/01/2024, 12:17Sa’am for seizures gone awry? – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/saam-for-seizures-gone-awry/1563/print4/7
I didn t recognize any LV Excess signs. She was dressed sporty and clean, hair braided. She seemed quite aware of
her surroundings.
I know that she experiences both the stiffening contraction of the tonic phase as well as the alternating
contraction/relaxation causing the jerking/shaking of the clonic phase. I hadn t thought to inquire about which of
these has been more pronounced, nor had I thought to consider the tightening aspect as potential LV Excess. I ll
investigate/contemplate more about this.
George_Mandler:
Those were grand mal as she had 1 month prior?
Did it stop after the 2 days and has she had one since? If she had another one then it seems frequency did
increase and I would consider if doing a 1x SJ+ on left even though it is a week or more later.
She had 6 full on grand mal seizures in 2 days and then nothing since. It s been 2-3 weeks, since I was out of town
for a while after her treatment.
That seems a reasonable parameter to do SJ Sup if she has another following.
On this note, I m curious if is this something that you ve experienced happening with Sa am at times a brief
exacerbation of symptoms? My sense from Toby s classes is that he doesn t tend to see that kind of result as a
positive sign per se, but leans more toward it as being possible mis-treatment
I appreciate the discussion, George. I feel more confident going forward. I ll have her come in and reinvestigate
those three pairings.
Thank you!!
Adina_Kletzel: May 13, 2021, 8:48pm
dylannb:
she slept really well, and talked about feeling relaxed and good,
Given the immediate positive reaction I would hesitate doing SJ+. Did you ask if there were any other factors right
before the seizures that could have contributed to their onset?
George_Mandler: May 14, 2021, 8:40pm
dylannb:
On this note, I m curious if is this something that you ve experienced happening with Sa am at times a brief
exacerbation of symptoms? My sense from Toby s classes is that he doesn t tend to see that kind of result as a
positive sign per se, but leans more toward it as being possible mis-treatment 04/01/2024, 12:17Sa’am for seizures gone awry? – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/saam-for-seizures-gone-awry/1563/print5/7
We had a recent discussion on this. Adverse reaction vs Healing crisis
My personal experience and clinical experience is that sometimes I can feel worse for a short while but then feel
better. But it is not the main symptom that feels worse but other things feel worse (achy etc). That 5 days since the
treatment seems like a bit far from treatment to say it is an adverse reaction.
Since these are so clear when they happen and infrequent I think time will tell you. Please keep us updated on any
developments in this interesting case.
George_Mandler: May 14, 2021, 8:44pm
Adina_Kletzel:
Given the immediate positive reaction I would hesitate doing SJ+. Did you ask if there were any other factors
right before the seizures that could have contributed to their onset?
yes I agree. Unless she does have an uptick in seizures in which case Dylan needs to get clear on what happens
during her seizures.
As an aside SJ+/LR+ is not one that is commonly toggled but I have a patient today where I do that dance as she is
on so many psych meds. Sometimes she shows up LR excess and sometimes SJ excess. (and for the record often
LI+, ST+, SI/KD+)04/01/2024, 12:17Sa’am for seizures gone awry? – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/saam-for-seizures-gone-awry/1563/print6/7
dylannb: May 15, 2021, 1:13am
Hi Adina.
Thanks for your response.
Yeah, I checked in with her about other possible triggers for the seizures, but we were unable to identify anything.
I ll investigate further when I see her next.
Another reason I wanted to inquire about delayed responses is because I had a case recently where I did HT+ for
low back and UB Ch thigh pain. This person seemed to settle well on the table (perhaps I m not very good at
gaging this response), and the next week he reported feeling improved back pain for the remainder of the day, and
slept really well that night not waking with pain at all, which was unusual for him. The next morning his right
hamstring stiffened up making it difficult/painful to bend and the pain at right posterior iliac area increased.
I considered this as mistreatment despite the initial positive (?) response and did UB+ on left. Immediately he
could bend his right leg fully with no pain and the tender/painful spots on iliac crest disappeared. He remains free
from iliac and thigh pain 2 weeks later clearly showing mistreatment from HT+. SP+ has since nearly resolved any
lingering L4/L5/SI-Joint pain.
This case has made me question the reliability of the initial response to some extent. Though, this was the next day
vs 5-6 days later. I suppose the further away from treatment the exacerbation of symptoms, the less weight given to
possible mistreatment.
Cheers!
mariayung: May 15, 2021, 7:25pm
Hi Dylan,
I find I have similar experience with delayed response as you and that has been a BIG question of mine. My
experience is that the patient will have a initial positive response, settled well on the table, feels great, symptom
gone, but 1 -2 weeks later, new symptoms related to the SAAM treatment will develop. It seems to me that the
SAAM treatment created the new imbalance, where the SAAM treatment push the body in a certain direction but
continues to go in that direction. The treatment corrected the initial imbalance but then it keeps going creating a
new imbalance. Toby says that as the treatment goes further and further out, there are so many other contributing
factors. Still, it is extremely unnerving when there are unexplained exacerbation of symptoms or unexplained new
symptoms that pop up that patient never experienced before.
George_Mandler: May 16, 2021, 5:22pm
mariayung:
My experience is that the patient will have a initial positive response, settled well on the table, feels great,
symptom gone, but 1 -2 weeks later, new symptoms related to the SAAM treatment will develop.04/01/2024, 12:17Sa’am for seizures gone awry? – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/saam-for-seizures-gone-awry/1563/print7/7
How do you know these are related to the Sa am treatment? Yes a delayed response can happen, but 1-2 weeks
later seems unusual.
mariayung: May 20, 2021, 10:03pm
I don t know for sure but it happens enough to get my attention and for me to take notice.