Epilepsy with cerebral congestion

Patient Information
Chen, a 38-year-old man from Tianjin, presented with epilepsy complicated by cerebral congestion.

Etiology
Chronic excessive liver fire, combined with prolonged daily lecturing (teaching English) and overexertion of mind and body, led to the condition.

Clinical Manifestations
Epileptic seizures occurring every few days to weeks, predominantly at night. Unconscious during episodes, he awoke with tongue bite marks, accompanied by mental fog, fatigue, and body aches. Pulse: abnormally taut and hard bilaterally. Upon inquiry, he admitted to concurrent cerebral symptoms: head heat, pain, and dizziness, previously assumed to be epilepsy-related.

Diagnosis
Epilepsy caused by abnormal neural dysfunction due to cerebral congestion. Excessive blood congestion in the brain compressed neural pathways, disrupting normal function. Treatment priority: address cerebral congestion first.

Prescription

​Liver-Sedating and Wind-Extinguishing Decoction (author’s formula for cerebral congestion)

​Addition: Three large whole centipedes (Scolopendra), known for antiepileptic efficacy.

Follow-up
After 10 doses, cerebral heat, pain, and dizziness resolved. Pulse remained forceful; formula slightly adjusted for another 10 doses until pulse normalized. Subsequently, focused on epilepsy treatment:

​Epilepsy-Healing Elixir (author’s formula): Taken twice daily with Dioscorea opposita (5 qian) decoction.

Outcome
No recurrence after two months of treatment. Medication discontinued; epilepsy cured.

Note:
The dual approach—first resolving cerebral congestion with liver-calming therapy, then targeting epilepsy—highlights the interplay between TCM pathophysiology (e.g., liver fire, blood congestion) and neurological disorders. Centipedes, a classic antispasmodic in TCM, synergized with the foundational formula to address both root (congestion) and branch (seizures).