Question: How is blepharospasm viewed in Chinese
medicine, and what can be done about it?
Answer: A 60-year old male patient
presented with a complaint of severe eyelid twitching that had worsened over
the last two months. He had consulted a neurologist, who diagnosed “benign
essential blepharospasm.” The standard
treatment was Botox injections every two months. He didn’t like that idea at
all, so he came to try acupuncture.
This patient owned a stressful
landscaping business, and had problems with the business and at home trying to
manage finances and raise three children. He was active, cycling up to a
hundred miles a week. He suffered from sleep deprivation due to insomnia and to
busyness, and he also had headaches. He was otherwise in good health, with no
history of drug or alcohol use. His pulse was very moderate, slow and evenly
balanced, but his tongue was quite purple.
How could a man this active show
signs of liver Qi stagnation? Could his stress be so strong that it allowed his
liver Qi to stagnate even with all that exercise? And, twitching usually
indicates liver wind, but in this case, was liver Qi stagnation the prominent
pattern? How much stagnation should I try to move, versus how much wind to try
to extinguish?
I decided to start with his
sleep, so I prescribed the always-reliable Suan Zao Ren Tang in tablets, to
help him sleep and to calm the liver. If acupuncture and this formula did not
improve things, I would prescribe a more focused raw herb formula.
At our second meeting, the
twitching had not changed at all, but his sleep had improved somewhat. He told
me that he’d forgotten to mention a history of loss of consciousness; he had
completely passed out, once in the shower two years ago and another time 3-4
years ago. This could be part of the liver wind pattern, so I made note of it,
even though it had not happened recently.
He had seen his ophthalmologist
about the twitch, and had been referred to a neuro-ophthamologist, whom he had
not yet seen at the time of this publication. His tongue was still quite a dark
purple, and he agreed to try a raw herb formula. Given his lack of improvement,
and the new information about fainting, I wrote the following formula:
Tian Ma, 10 g
Gou Teng,10 g
Mu Gua, 10 g
Du Zhong, 10 g
Mu Li (prepared), 20 g
Jiang Can, 10 g
Bai Ji Li, 10 g
Ju Hua, 10 g
Bai Shao, 10 g
This formula extinguishes internal wind, sedates the liver, cools
the liver and relieves spasm. I told him to come back in a week, and to have
consumed all three bags of the formula!
When I next saw him, he reported that the twitch was improved in
frequency and severity. He no longer had to hold his face to keep it steady.
Better still, his tongue had become a clear pink with very little trace of
purple. That’s where things stand now, after three visits. He’d only used up
one bag of the tea, though, because of being too busy.