Case Study: 9 year old boy, with chief complaint of dizziness

[Guest guest]

I am looking for support with this case.

Thanks in Advance,

Jeffrey Szilagyi L.Ac.

 

 

5+ weeks.

He can't find his equilibrium without holding on to something, needs

assistance in walking. Watching him looks rather odd, because his

feet and lower body are relatively stable, but his upper body is

disoriented, tipsy, he leads with his head. He complains of feeling

like the ground is in motion.

 

Onset took place following these factors:

Strong sore throat just prior, second of two colds in that time frame.

Went to the beach and two days prior- swimming in chilly Pacific in

early March. Reports being tumbled by wave. On further questioning

doesn't sound that strong of a tumble. Reports feeling a chill after

getting out.

 

Also complains of frontal headache, stronger on right side. This is a

more recent symptom.

 

Has had battery of tests: CBC, Multiple MRI's , may be looking at

spinal tap (any opinions on this)

WBC's show Acute Viral Pattern: Functionally higher Total WBC (7.5)

Functionally lower Neutrophils (40%) and Functionally high

Lymphocytes (46%)

 

Deep Tired Face, a bit sad, with puffiness… since a recent course of

prednisone Tx. Which the parents stopped after 3 days.

Kid. Pulses deep

Remaining pulses: Rapid (108) and very Slippery

I am approaching the case as a trapped EPI (Viral Infection)

With heat effecting the Shao Yang Channels and concomitant Spleen

def. damp and Kidney Qi def.

Initial ATx.: TB 3, TB 17, Sp 9,

Herbs: KW's Pediartric Ear Formula 65%

+

Chuan Xiong 6%

Bai Zhi 7%

Tian Ma 7%

Shi Chang Pu 3%

Sheng Jiang 5%

Ju Hua 7%

Nutritionally, Advising a diet that avoids foods promoting damp in

Spleen.

[Guest guest]

Jeff,

 

Have they ruled out viral labyrinthitis? The middle ear gets affected

after a viral infection. It can last from a few days to a few months.

Any movement of the head incraeses the dizziness. If that's what it

is, Chuan Xiong Cha Tiao Wan can help if the pattern fits it. Somewhat

similar to your formula.

 

- Bill Schoenbart

 

 

Chinese Medicine , " jeffreyszilagyi "

<marinhealth wrote:

>

> I am looking for support with this case.

> Thanks in Advance,

> Jeffrey Szilagyi L.Ac.

>

>

> 5+ weeks.

> He can't find his equilibrium without holding on to something, needs

> assistance in walking. Watching him looks rather odd, because his

> feet and lower body are relatively stable, but his upper body is

> disoriented, tipsy, he leads with his head. He complains of feeling

> like the ground is in motion.

>

> Onset took place following these factors:

> Strong sore throat just prior, second of two colds in that time frame.

> Went to the beach and two days prior- swimming in chilly Pacific in

> early March. Reports being tumbled by wave. On further questioning

> doesn't sound that strong of a tumble. Reports feeling a chill after

> getting out.

>

> Also complains of frontal headache, stronger on right side. This is a

> more recent symptom.

>

> Has had battery of tests: CBC, Multiple MRI's , may be looking at

> spinal tap (any opinions on this)

> WBC's show Acute Viral Pattern: Functionally higher Total WBC (7.5)

> Functionally lower Neutrophils (40%) and Functionally high

> Lymphocytes (46%)

>

> Deep Tired Face, a bit sad, with puffiness… since a recent course of

> prednisone Tx. Which the parents stopped after 3 days.

> Kid. Pulses deep

> Remaining pulses: Rapid (108) and very Slippery

> I am approaching the case as a trapped EPI (Viral Infection)

> With heat effecting the Shao Yang Channels and concomitant Spleen

> def. damp and Kidney Qi def.

> Initial ATx.: TB 3, TB 17, Sp 9,

> Herbs: KW's Pediartric Ear Formula 65%

> +

> Chuan Xiong 6%

> Bai Zhi 7%

> Tian Ma 7%

> Shi Chang Pu 3%

> Sheng Jiang 5%

> Ju Hua 7%

> Nutritionally, Advising a diet that avoids foods promoting damp in

> Spleen.

>

[Guest guest]

-Jeff, did you observe any signs related to nausea or vomiting? That

can help you differentiate where the pathologial location is (are).

Besides, your presciption is not totally in line with your path of

thoughts about this viral approach. Last, I did not find the basic

data, the tongue condition (correct me if I missed).Jin Gui Alisma

Decoction (ze xie tang) should (may) be included as a base formula

whatever diagnosis you have come up with.

My two cents.

 

SUNG

[Guest guest]

It sounds like benign paoxysmal positional vertigo (BPPV). Does he have

nystagmus (his pupils seems to move rapidly) with certain movements (like when

going to lie down)? This is a pathology of the inner ear - which would make

sense with his history of swimming. Some PTs specialize in this treatment, which

consists of a series of exercises.

Sorry this is not too TCM of an answer. But I have experience with this and have

used the positional exercises in conjunction with points to clear inner wind and

ear candling with much success.

Jessica Fritz, L.Ac.

 

 

 

You rock. That's why Blockbuster's offering you one month of Blockbuster Total

Access, No Cost.

 

 

[Guest guest]

Why would you treat with an ear formula? none of his signs and symptoms say ear.

They say wind. The ground moves, so it is excess. Don't let Western ideas of

balance lead your Chinese diagnosis. You will certainly fail if you do.

 

Douglas Knapp

Doctoral Fellow, L.Ac.

Full Moon Acupuncture

1600 York Avenue

New York, NY 10028

212-734-1459

 

 

jeffreyszilagyi <marinhealth

Chinese Medicine

Monday, April 7, 2008 2:00:13 PM

Case Study: 9 year old boy, with chief complaint of dizziness

 

I am looking for support with this case.

Thanks in Advance,

Jeffrey Szilagyi L.Ac.

 

5+ weeks.

He can't find his equilibrium without holding on to something, needs

assistance in walking. Watching him looks rather odd, because his

feet and lower body are relatively stable, but his upper body is

disoriented, tipsy, he leads with his head. He complains of feeling

like the ground is in motion.

 

Onset took place following these factors:

Strong sore throat just prior, second of two colds in that time frame.

Went to the beach and two days prior- swimming in chilly Pacific in

early March. Reports being tumbled by wave. On further questioning

doesn't sound that strong of a tumble. Reports feeling a chill after

getting out.

 

Also complains of frontal headache, stronger on right side. This is a

more recent symptom.

 

Has had battery of tests: CBC, Multiple MRI's , may be looking at

spinal tap (any opinions on this)

WBC's show Acute Viral Pattern: Functionally higher Total WBC (7.5)

Functionally lower Neutrophils (40%) and Functionally high

Lymphocytes (46%)

 

Deep Tired Face, a bit sad, with puffiness… since a recent course of

prednisone Tx. Which the parents stopped after 3 days.

Kid. Pulses deep

Remaining pulses: Rapid (108) and very Slippery

I am approaching the case as a trapped EPI (Viral Infection)

With heat effecting the Shao Yang Channels and concomitant Spleen

def. damp and Kidney Qi def.

Initial ATx.: TB 3, TB 17, Sp 9,

Herbs: KW's Pediartric Ear Formula 65%

+

Chuan Xiong 6%

Bai Zhi 7%

Tian Ma 7%

Shi Chang Pu 3%

Sheng Jiang 5%

Ju Hua 7%

Nutritionally, Advising a diet that avoids foods promoting damp in

Spleen.

 

 

 

 

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[Guest guest]

Try Master Tong's points 77.01 and 55.06 bilaterally and treat for sinus

infection.

 

Luck,

 

 

[Guest guest]

treat for a sinus infection?!!!

guys, please use Diagnosis to treat. Does this kid show signs

of sinus infection? No! He is showing you signs of a lingering pathogenic

factor --wind. That's what the vertigo is all about. An excess pattern in this

case since the room is spinning as opposed to him spinning.

 

Treat the pattern.

Use Xiao Chai Hu Tang (classic pediatric formula and classic formula for the

treatment of retained pathogenic factors, i.e., half interior, half exterior

conditions) and modify to address more of the wind and/or any other signs of

excess or deficiency.

 

Tui Na works great for this in children.

 

My practice is almost exclusively children and I've treated this before.

 

Jacqueline Luna-Knapp, L.Ac, MS

Doctoral Fellow

Full Moon Acupuncture, PC

1600 York Ave

New York, NY 10028

212-734-1459

Fax 212-734-1465

 

Any path is only a path, and there is no affront,

To oneself or to others, in dropping it if that is

What your heart tells you… Look at every path

Closely and deliberately. Try it as many times

As you think necessary. Then ask yourself, and

Yourself alone, one question… Does this path

Have a heart? If it does, the path is good; if it

Doesn’t it is of no use.

 

 

The Teachings of Don Juan

 

 

Donald Snow <don83407

Chinese Traditional Medicine

Friday, April 11, 2008 7:14:02 PM

RE: Case Study: 9 year old boy, with chief complaint of

dizziness

 

 

Try Master Tong's points 77.01 and 55.06 bilaterally and treat for sinus

infection.

 

Luck,

 

 

[Guest guest]

This person asked for an opinion and help. If you don't like our opinion, offer

your own. But your critique was unsolicited. What credentials do you bring to

the table to critique another practitioners opinion? I notice that you are a

Doctoral Fellow and I commend you. However, I am a DAOM graduate and you are

not qualified to critique my opinions, and I didn't ask for a critique. Mind

your busness and I'll mind mine.

 

 

[Guest guest]

First of all, that was not a critique. Just a suggestion. To everybody

actually. Not just to you. Too many of us get us lost with the Western

Diagnosis when we try to come up with a Chinese Diagnosis.

 

Your attitude leaves a lot to be desired.

 

What experience I bring to the table is 10 years of treating children.

But you wouldn't care anyway.

 

 

 

Jacqueline Luna-Knapp, L.Ac, MS

Doctoral Fellow

Full Moon Acupuncture, PC

1600 York Ave

New York, NY 10028

212-734-1459

Fax 212-734-1465

 

Any path is only a path, and there is no affront,

To oneself or to others, in dropping it if that is

What your heart tells you… Look at every path

Closely and deliberately. Try it as many times

As you think necessary. Then ask yourself, and

Yourself alone, one question… Does this path

Have a heart? If it does, the path is good; if it

Doesn’t it is of no use.

 

 

The Teachings of Don Juan

 

 

Donald Snow <don83407

Chinese Traditional Medicine

Sunday, April 13, 2008 4:13:59 PM

RE: Case Study: 9 year old boy, with chief complaint of

dizziness

 

 

This person asked for an opinion and help. If you don't like our opinion, offer

your own. But your critique was unsolicited. What credentials do you bring to

the table to critique another practitioners opinion? I notice that you are a

Doctoral Fellow and I commend you. However, I am a DAOM graduate and you are

not qualified to critique my opinions, and I didn't ask for a critique. Mind

your busness and I'll mind mine.

 

 

[Guest guest]

Hi Donald & Jacqueline,

 

It is permitted (indeed desirable) to discuss and criticise an

argument / opinion / methodology. However, we should extended common

courtesy to colleagues whose professional opinions may differ from our

own.

 

I respectfully ask both of you to conduct any personal differences

off-list.

 

Flaming (personal insult / attack / criticism / denigration)is not

acceptable on a professional discussion list. To maintain civil

discussion and peace on a List, many List Masters expel members who

flame, especially if such behaviour recurs.

 

Best regards,

 

[Guest guest]

Hi Phil,

 

Thanks for weighing in here. As the List Master I need to ask that all

discussion be kept professional and civil. Flaming is not tolerated,

as can be attested to, I am not averse to tossing folks out on their

ear if they can't play well with everyone else.

 

- Mark

 

 

 

On Mon, Apr 14, 2008 at 1:44 PM, progersie1 < wrote:

Hi Donald & Jacqueline,

>

> It is permitted (indeed desirable) to discuss and criticise an

> argument / opinion / methodology. However, we should extended common

> courtesy to colleagues whose professional opinions may differ from our

> own.

>

> I respectfully ask both of you to conduct any personal differences

> off-list.

>

> Flaming (personal insult / attack / criticism / denigration)is not

> acceptable on a professional discussion list. To maintain civil

> discussion and peace on a List, many List Masters expel members who

> flame, especially if such behaviour recurs.

>

> Best regards,

>

>

>

[Guest guest]

I wasn't try to flame. I thought I was discussing the topic at hand.

Someone didn't like the disagreement and didn't respond as cordially as

expected.

Anyway, point taken.

 

Jacqueline Luna-Knapp, L.Ac, MS

Doctoral Fellow

Full Moon Acupuncture, PC

1600 York Ave

New York, NY 10028

212-734-1459

Fax 212-734-1465

 

Any path is only a path, and there is no affront,

To oneself or to others, in dropping it if that is

What your heart tells you… Look at every path

Closely and deliberately. Try it as many times

As you think necessary. Then ask yourself, and

Yourself alone, one question… Does this path

Have a heart? If it does, the path is good; if it

Doesn’t it is of no use.

 

 

The Teachings of Don Juan

 

 

Mark Milotay <mark

Chinese Medicine

Monday, April 14, 2008 4:49:41 PM

Re: Case Study: 9 year old boy, with chief complaint of dizziness

 

Hi Phil,

 

Thanks for weighing in here. As the List Master I need to ask that all

discussion be kept professional and civil. Flaming is not tolerated,

as can be attested to, I am not averse to tossing folks out on their

ear if they can't play well with everyone else.

 

- Mark

 

On Mon, Apr 14, 2008 at 1:44 PM, progersie1 < (AT) tinet (DOT) ie> wrote:

Hi Donald & Jacqueline,

>

> It is permitted (indeed desirable) to discuss and criticise an

> argument / opinion / methodology. However, we should extended common

> courtesy to colleagues whose professional opinions may differ from our

> own.

>

> I respectfully ask both of you to conduct any personal differences

> off-list.

>

> Flaming (personal insult / attack / criticism / denigration) is not

> acceptable on a professional discussion list. To maintain civil

> discussion and peace on a List, many List Masters expel members who

> flame, especially if such behaviour recurs.

>

> Best regards,

>

>

>

 

 

 

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[Guest guest]

Jeff,

-Due to the differences in our training in tcm, i don't know what

medicinals included in KW's Pediatric Ear Formula. All I can say is

chuan xiong is too warm and the formula I have in mind is as

follows, for your reference. The amazing thing about tcm is we can base

upon the pattern to prescribe rather than upon individual laboratory

test result and it should work in one way or the other.

 

chen pi, fu ling, bai zhu, ze xie, tu fu ling, zhu yu, ban lan geng,

xian he cao

 

Questions I would like to know:

-how often the onset of his dizziness, his appetite, his tongue

condition, any phlegm, any enuresis etc.

 

SUNG, yuk-ming, PhD

[Guest guest]

I don't want to contribute to dragging this one out, but my read was that

jacqueline was talking generally to everyone (rather than engaging in

flaming towards a certain individual) emphasizing a basic point of TCM,

which is to make a TCM dx and tx plan, and not to get mired in the easy

tendency to base a dx according to west. s/s. i felt her point was valid.

though i myself agreed that this seemed to be a w/c attack that moved

internally, and with the western info of the cbc was also thinking that

utilizing anti viral herbs (isatis', jin yin hua, lian qiao) and ch & toxins

(bai he she she cao) might be appropriate in light of the western findings.

in addition to the ext wind herbs (ban xia, bai zhu, tian ma tang) points

as gb20, 31, 34, liv 3, liv 8 could be included. this is just my initial

thoughts on a quick read. but i do think jacqueline's point is well taken

in making a dx based on the tcm s/s, rather than western tests. it's an

easy and tempting pitfall we must be mindful in avoiding, and i felt she was

acting appropriately in waving a yellow flag on the issue.

 

i would also point out that when objects seem to be moving around the

person, that is vertigo. dizziness is when the person feels as though they

are moving in space.

 

in harmony,

 

kath

 

On Mon, Apr 14, 2008 at 4:53 PM, jacqueline luna <docluna wrote:

 

> I wasn't try to flame. I thought I was discussing the topic at hand.

> Someone didn't like the disagreement and didn't respond as cordially as

> expected.

> Anyway, point taken.

>

> Jacqueline Luna-Knapp, L.Ac, MS

> Doctoral Fellow

> Full Moon Acupuncture, PC

> 1600 York Ave

> New York, NY 10028

> 212-734-1459

> Fax 212-734-1465

>

> Any path is only a path, and there is no affront,

> To oneself or to others, in dropping it if that is

> What your heart tells you… Look at every path

> Closely and deliberately. Try it as many times

> As you think necessary. Then ask yourself, and

> Yourself alone, one question… Does this path

> Have a heart? If it does, the path is good; if it

> Doesn't it is of no use.

>

>

> The Teachings of Don Juan

>

>

> Mark Milotay <mark

> Chinese Medicine

> Monday, April 14, 2008 4:49:41 PM

> Re: Case Study: 9 year old boy, with chief complaint of

> dizziness

>

> Hi Phil,

>

> Thanks for weighing in here. As the List Master I need to ask that all

> discussion be kept professional and civil. Flaming is not tolerated,

> as can be attested to, I am not averse to tossing folks out on their

> ear if they can't play well with everyone else.

>

> - Mark

>

> On Mon, Apr 14, 2008 at 1:44 PM, progersie1 < (AT) tinet (DOT) ie> wrote:

> >

> >

> >

> >

> >

> >

> > Hi Donald & Jacqueline,

> >

> > It is permitted (indeed desirable) to discuss and criticise an

> > argument / opinion / methodology. However, we should extended common

> > courtesy to colleagues whose professional opinions may differ from our

> > own.

> >

> > I respectfully ask both of you to conduct any personal differences

> > off-list.

> >

> > Flaming (personal insult / attack / criticism / denigration) is not

> > acceptable on a professional discussion list. To maintain civil

> > discussion and peace on a List, many List Masters expel members who

> > flame, especially if such behaviour recurs.

> >

> > Best regards,

> >

> >

> >

>

>

>

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