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CONCUSSION, POST-CONCUSSION SYNDROME

GENERAL

Clinical Manifestations	Post-concussion syndrome, also known as post-concussive syndrome or PCS, is a set of symptoms that may continue for weeks, months, or a year or more after a concussion – a mild form of traumatic brain injury (TBI). The rates of PCS vary, but most studies report that about 15% of individuals with a history of a single concussion develop persistent symptoms associated with the injury. A diagnosis may be made when symptoms resulting from concussion last for more than three months after the injury. Loss of consciousness is not required for a diagnosis of concussion or post-concussion syndrome.
Treatment Principle
Herb Formulas	Xiao Yi Tang San Bian Di Huang Tang
Points

EXTERNAL WIND

Clinical Manifestations	Headache due to Wind attack Headache in any part of the head Fever and chills Dizziness Nasal congestion Stuffy nose Clear or white nasal discharge Sneezing Body aches Nasal obstruction Vertigo Aversion to Cold Copious sputum T: Normal C: Thin and white P: Superficial
Treatment Principle	Dispel Wind Alleviate pain
Herb Formulas	Chuan Xiong Cha Tiao San
Points

SHAO YANG FU WITH UNDERLYNIG LIVER QI STAGNATION

Clinical Manifestations	Dizziness Headache Fullness and distention in the chest Irritability Occasional fright palpitations Urinary difficulty Constipation Delirious speech Insomnia Subcardiac distention Palpitations at the abdomen Melancholia Fear Agitation Unsteadiness Tends toward mania and convulsions Tends toward fatigue and clumsiness of limbs Dysuria Excitability Anxiety Depression Tinnitus Deafness Profuse expectoration of Phlegm Bitter taste in the mouth Palpitations Pale face Oliguria A sensation of extreme heaviness of the body Fatigue Inability to rotate the trunk Difficulty moving the body T: Red C: Slippery P: Wiry and rapid
Treatment Principle	Harmonize the Shao Yang Unblock the three Yang Stages Sedate and calms the Spirit Alleviates spasm Adjusts the Central Nervous System
Herb Formulas	Chai Hu Jia Long Gu Mu Li Tang
Points	GB-34, LIV-3, SJ-6 To harmonize the Liver and Gall Bladder: GB-34, LIV-3, LIV-14, SJ-5 For nausea and vomiting: PC-6, SP-4, ST-36 For headache: GB-1, GB-8, GB-14, Taiyang

HEART YANG NOT VIGOROUS: WATER QI INSULTS THE HEART WITH KIDNEY YANG DEFICIENCY

Clinical Manifestations	Palpitations Dysuria Shortness of breath Dyspnea Dizziness Muscular twitching Whole body edema Cold body Icy limbs Cold abdomen with watery stools Edema of limbs Cough Pale complexion Lips and nails cyanosed Soreness and aching of the shoulders and back Abdominal pain Diarrhea T: Pale or Purple (Lavender) C: White and greasy P: Deep or Deep and minute
Treatment Principle	Support Yang Expel Cold Promote diuresis
Herb Formulas	Zhen Wu Tang
Points	Moxa needle DU-4, KI-3, KI-7, PC-5, PC-6, REN-4, REN-6, REN-9, REN-17, SP-6, SP-9, UB-15, UB-23

HEART BLOOD AND SPLEEN QI DEFICIENCY

Clinical Manifestations	Memory loss Forgetfulness Absent-mindedness Lack of concentration Blurred vision Spots before the eyes Fatigue Palpitations Insomnia Much dreaming Easily startled Depression Irritability Anxiety Worry Phobias Panic attacks Fear Maybe headaches and dizziness Four limbs tired and lethargic Loss of appetite Distention and fullness of the epigastrium and abdomen Loose stools Sallow complexion Copious, pale menses Uterine bleeding or Light menstrual flow or Amenorrhea T: Pale C: Thin and white P: Thready and weak or Wiry, slightly thready and moderate
Treatment Principle	Reinforce and Benefit the Heart and Spleen
Herb Formulas	Gui Pi Tang modified
Points	DU-16, DU-20, HT-7, LIV-3, SP-6 For severe impaired memory and unclear speech: + UB-17, UB-18 For stagnant Heat in the Stomach and Heart: + PC-7, ST-44 For stagnant Heat in the Liver: + UB-18, UB-47 For a bland taste in the mouth and a thick tongue coat: + SP-9 For epileptic symptoms: + LI-4, DU-14 HT-7, REN-4, SP-1, SP-6, ST-36, UB-15, UB-20

LIVER WIND STIRRING INTERNALLY: LIVER YANG (FIRE) GENERATES WIND

Clinical Manifestations	Emotional impetuosity Rashness Dizziness Vertigo A feeling of distention in the eyes Tinnitus Feverish sensation in the head Pounding headaches Irritability Angers easily Agitation Restlessness Flushed face as if intoxicated Swelling of the eyes Maybe vomiting of white foam or bitter bile Frequent belching Progressive motor dysfunction occurring over hours to days Development of facial asymmetry Sudden loss of consciousness Spasms Heat and pain of the brain Mental confusion with moments of lucidity Inability to fully recover after loss of consciousness Hiccups Belching Irritable Heat in the Heart Deviation of mouth and eyes Tremors Limited mobility of the limbs T: Red or Dark red C: Little or Yellow P: Wiry, Excess and long or wiry and rapid
Treatment Principle	Sedate the Liver Extinguish Wind Nourish Yin Anchor Yang
Herb Formulas	Zhen Gan Xi Feng Tang Ling Jiao Gou Teng Tang modified
Points	Bleed the Jing-Well points of Six Hand Channels, needle DU-20, DU-26, GB-20, GB-34, KI-1, KI-3, LIV-2, LIV-3, PC-8, UB-18, UB-23 DU-16, DU-20, GB-20, KI-1, LIV-3, Sishencong For irritability, agitation and restlessness: + UB-18, UB-47 For nausea, vomiting and constipation: + PC-6, SJ-6 For epileptic symptoms: + DU-14, LI-4 For insomnia, impaired memory and unclear speech: + DU-24, GB-13

KIDNEY QI DEFICIENCY

Clinical Manifestations	A history of traumatic injury to the head Listlessness Slow, difficult thinking Decreased visual acuity Markedly decreased memory Dizziness Vertigo Tinnitus Low back and lower leg soreness and weakness T: Pale C:Thin P: Thready and weak
Treatment Principle	Tonify the Kidneys Strengthen the brain Increase the marrow Strengthen Jing
Herb Formulas	Zi Yin Da Bu Yin
Points	DU-16, DU-20, GB-39, KI-3, UB-23, UB-52 For bone-steaming or tidal fever, aching Heat in the feet or knees, a red tongue and a rapid pulse: + DU-14, HT-6 For palpitations, fright, fear, irritability, agitation and restlessness: + Sishencong For a severely impaired memory and unclear speech: +Sishencong For epileptic symptoms: + DU-14, LI-4, LIV-3

QI AND BLOOD STAGNATION

Clinical Manifestations	Traumatic injury to the head Emotional lability (exaggerated changes in mood or affect in quick succession) Lethargy Depression Scanty speech or Aphonia Difficult or slow thinking Poor memory Piercing headache Heart pain Stomach pain Abdominal pain Back pain Leg pain Arm pain Chest and flank distention and pain Bruising and swelling due to traumatic injury Rheumatic pain Fixed abdominal masses Internal or external ulcerations Dark or echymosis spots Scrofula T: Dark or Purple with purple spots C: Thin and white or thin and yellow P: Wiry or Choppy
Treatment Principle	Activate the Blood Dispel Blood Stasis Regulate Qi Unblock the collaterals Alleviate pain
Herb Formulas	Huo Luo Xiao Ling Dan Xiao Yao San modified
Points	DU-16, DU-20, GB-20, LIV-3, PC-5, Sishencong With emotional lability, a bitter taste in the mouth, irritability and agitation: + UB-18, UB-47 With pronounced Spleen Qi Deficiency: + ST-36 With pronounced Yin and Blood Deficiency: + SP-6 With marked cold hands and feet: + moxa or moxa needle REN-4 With insomnia, impaired memory and unclear speech: + DU-24, GB-13 With irritation, agitation and restlessness: + KI-1, LIV-1 With severe Blood Stasis: + UB-17

QI AND BLOOD STAGNATION DUE TO DAMPNESS

Clinical Manifestations	Dizziness Vertigo Tinnitus Continuous cramping pain in the abdomen Pain is not severe Pain is relieved by pressure Edema of the feet Urinary difficulty Slight edema (primarily of the lower limbs) Symptoms generally occur during pregnancy Pale face Fatigue Heaviness of head Lassitude Lower abdominal pain Lumbago Edema Abdominal pain with edema during pregnancy due to Blood Deficiency and abnormal water circulation Oliguria Palpitations Cold feet Extreme coldness of the hands and feet Weakness and numbness of lower back and legs during pregnancy or postpartum Mal position of the fetus Dysmenorrhea Irregular menstruation Right upper quadrant pain Hepatomegaly Anemia Lack of energy Sore back Thirst with no desire to drink T: Pale or pink maybe petechiae on margin C: Thin or Greasy white P: Deep and weak or Soft, floating, small and slow or Wiry and small or Wiry and rough
Treatment Principle	Nourish Liver Blood Soften the Liver Spread Liver Qi Strengthen the Spleen Resolve Dampness Reinforce the Spleen and Kidney
Herb Formulas	Dang Gui Shao Yao San
Points

BLOOD STAGNATION

Clinical Manifestations	After the acute traumatic injury, there is: Unclear thinking Spirit-Mind haziness and clouding Unclear speech Vexation Agitation Restlessness Headache Dizziness Symptoms may be worse at night Persistent tinnitus or Hearing loss There may be black or dark discharge from the ear or Dark matter mixed in with the ear wax Maybe an earache or pain Chronic headaches Spider navii on the face, neck and trunk Vertigo Chronic tinnitus Hair loss Dark purple complexion or Blue or green facial complexion with or without rosacea or vitiligo Darkness around the eyes Brandy nose Progressive emaciation Abdominal distention Purplish discoloration of the sinews Tidal fever Dizziness Deafness Pale face Cyanosis Phthisis Muscle weakness Sudden loss of vision Pain that is fixed, stabbing and /or severe Pan is worse with pressure Dark complexion Fixed, palpable masses Bleeding with clots Purple lips Purple nails Dry skin Varicose and spider veins Cold hands and feet Tendency to hemorrhage dark blood or clots T: Dark and purplish C: White P: Wiry and choppy or Thready and choppy
Treatment Principle	Activate the Blood Break up Stagnation Clear and open the ears
Herb Formulas	Tong Qiao Huo Xue Tang modified Xue Fu Zhu Yu Tang Fu Yuan Huo Xue Tang Chinese Patent Medicines: Fu Fang Dan Shen Pian Sheng Tian Qi Pian
Points	SP-6, SP-10, ST-36, UB-17, UB-40 Choose two or three of the following: GB-2, GB-20, GB-39, KI-3, SI-19, SJ-17, SJ-21, SP-6, SP-10, UB-17 DU-16, DU-20, GB-20, LI-4, Sishencong, SP-6 For, insomnia, impaired memory and unclear speech: + DU-24, GB-13 For vexation, agitation and restlessness: + KI-1, LIV-1 For severe Blood Stagnation: + UB-17

TURBID PHLEGM OBSTRUCTING THE CHANNELS AND COLLATERALS

Clinical Manifestations	Sudden collapse Loss of consciousness Clenched jaws Fullness, extreme pain, and a cold sensation in the chest and abdomen Purple or blue lips Sudden loss of consciousness Coma An urge to vomit and defecate without doing either Abdominal pain with chest distention Mental upset Paraphasia Diarrhea Vomiting Excessive mucus and saliva Breath cold Pale complexion Cold extremities Staring eyes T Pale C: White and slippery or greasy P: Deep and slippery or Deep, excess and slow or Wiry, tight and Excess
Treatment Principle	Warm and Aromatically Open the Orifices Move Qi Expel dirt Transform turbidity Clear Phlegm
Herb Formulas	Su He Xiang Wan
Points	Bleed the Jing-Well points of the Six Hand channels, needle DU-20, DU-26, KI-1, LIV-3, PC-5, ST-40, UB-20