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Brain injury


#1

Submitted By: pi

I am going to be working on a 16 year old boy who fell and suffered a brain injury, and would appreciate any ideas from other practitioners about how to approach treating him and what points might be most effective. I will be using tuning forks (sound / vibration) on the acupuncture points.

'R' had his brain injury to the right side of his head on August 2006 and was in the hospital for 3 months in a drug induced coma. He had 3 hematomas on his right front temporal lobe and 1 on his left. He had 6 operations to drain fluid and blood around his brain, and to install a permanent shunt on the right side of his head which drains excess fluid into his stomache and is controlled by an external control that works with magnets. He was unable to use the left side of his body (mouth drooped, arm, leg) for a month much like a stroke victim, and he experienced pain in his left toe which spread to his entire foot. Through physical therapy he is now able to walk with a limp though his left side is still weaker (mostly hip, knee, feet) and the pain has subsided. He developed tendonitis on his right knee from overcompensating, and got a cortisone shot which helped.

He is on the medication Neurontin for seizures and nerve pain in his foot. The causes of seizures were alcohol, strobe lights, fatigue, and one time his eyes fixed on a light in the ceiling, started twitching, and resulted in a seizure. He is also taking Valproic Acid as an anti-seizure medication, as well as a high blood pressure medication.

Prior to the accident, for 3 years, R was taking ADHD and anti-depressant medications (Adderall & Zoloft) for mood disorders. He had explosive mood swings and rage episodes, and frontal lobe issues with impulsivity.

After the accident, he was taken off all these medications, and he no longer exhibits the explosive anger or intense mood swings. He still has his ups and downs, but they are less severe and he exhibits more of the manic upswing like laughing manically, out of proportion to the situation. He gets impatient and frustrated and says, "I can't do this", and throws things across the room. There is a component of obsessiveness around certain things like cars.

He has started going back to school, taking 1 class, and is going to an occupational and speech therapist to help his brain get organized and help him recognize when he feels impulsive and not to necessarily act on that impulse. He lost over 50# and is now working out at a gym 2X a week to get his strength back. He seems to be always hungry to the point of compulsion. He struggles with an inability to focus, and doesn't seem to be able to think as deeply on subjects as he used to when he was on ADHD meds.

Thanks for any input! Btw, am I posting this in the right forum?


#2

This is a fairly complicated case and a proper point prescription would require a full diagnostic intake in Chinese Medicine terms. There are also many systems and theories related to treating brain issues which vary considerably. From the tam healing system, the mood swings, etc. are most likely related to the damage to the r frontal lobe. Using massage in the area of C2 on that side and points such as GB 13 on the right side, would be helpful to stimulate that area. Other general tcm points such as GV 20 to bring energy to the brain and then points to deal with Qi Deficiency and Dampness which it sounds like he may have from what you mentioned. Those can be found here.


#3

Thanks Chad for the reply. I was not planning to work on his head directly at all because of the shunt and the many recent surgeries, but thought I might work distally to help build and balance his chi. To that end, I was thinking of using the Du Mai (8 Extras) for the brain, and Ren Mai (8 Extras) for Kidney yin deficiency and agitated nervous system, as well as some of the other points mentioned in Qi Deficiency. I may work off body in the field over his head also.
Can you clarify what was mentioned that made you think he had Dampness?
Thanks for any input!


#4

You are right to be cautious about working on the scalp. As an acupuncturist I would do it as one of the main effects of needling is the reduction of local inflammation which would be helpful in this case. The points and areas you have decided on will be helpful and are more appropriate choices for a non-acupuncturist with regards to safety. If you are familiar with energy healing techniques, I would use them to bring energy up and through the frontal lobe of the brain, that will be helpful for him.

With regards to the dampness, as I said, it is hard to give strong recommendations without a complete diagnosis. The dampness "guess" was based primarily on his weight issues, but it is also involved in many cases of limited mobility such as brain traumas and post stroke. Only a good look at his tongue, along with other signs, could confirm this however.

I wish him all the best and am certain that you will be able to speed his recovery.


#5

This sounds like a tough case, but I'm sure you can help this patient with acupuncture and healing work. I would also consider referring him to a cranio-sacral therapist perhaps? I don't do cranio myself, so I'm not sure if it is something good to try...but maybe.

Good luck with this,

Tara


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