Dizziness and Vertigo

What is Vertigo ?  

Vertigo, from the perspective of Traditional Chinese Medicine (TCM), consists of two different forms of discomfort in the head, called Xuan Yun (眩晕). Xuan is defined as experiencing giddiness or a blackout all of sudden, whereas Yun is a feeling that you or your environment is moving or spinning. This problem is commonly seen due to high blood pressure, arteriosclerosis, anaemia, neurosis, labyrinth disease, cervical spondylosis, brain tumour, amongst others. Severe vertigo may be caused by Ménière’s disease, a condition that affects the inner ear, which can cause hearing loss, tinnitus and a feeling of fullness or congestion in the ear. In TCM, the earliest mention of the term vertigo（眩冒）was in the ancient medical text, Huangdi Neijing, which stated that “the causes of vertigo is most likely related to the liver”. It is difficult to link a specific anatomical part to the term Liver (肝) as defined by the Chinese physician, but rather it refers to a functional complex, which may include the functional system of the liver as well as other parts surrounding it. The onset of vertigo can be due to factors such as a fluctuation in emotion (情志不遂), ageing and deficiencies in Kidney Yin (年高肾亏), after a serious illness (病后体虚), uncontrolled diet (饮食不节) and blood stasis due to injury (跌仆损伤，瘀血内阻). Even though the root causes of vertigo may be due to the aforementioned reasons, from the TCM point of view, pathological changes are divided into two: the excess, due to pathogenic wind or fire, phlegm or blood stasis disturbing the brain; and the deficiency, which is associated with the asthenia of Qi and blood, lack of Liver or Kidney Yin to nourish the brain. Common treatments for vertigo are acupuncture and prescription of Chinese herbal medicine. Depending on the symptoms of vertigo shown, different acupuncture points and Chinese herbal medicine will be prescribed (see below). Different acupuncture methods can also be applied to treat vertigo. These include body, ear and scalp acupuncture. One should consider the internal and external factors in order to prevent vertigo   

How can acupuncture help ?  

 There are many ways to approach treatment of this condition with Traditional Chinese medicine. This will depend upon the patients individual overall pattern rather than just the symptom of dizziness. This is in accordance with the Chinese ideology of treating the root of a person’s health issues.  There are multiple diagnostic patterns or combination of patterns that may cause dizziness ( vertigo) Among them are : Excess conditions:  1. Lv yang generating wind- arising from emotional issues or KD yin deficiency;  signs and symptoms are dizziness, red face, irritability, possibly tremors/tics, red tongue with thin yellow coat, wiry, rapid or slippery pulse. Treatment points may include LV 2, gb20, du20, gb34, sp6. 2. Phlegm damp retention- arising from st/ sp weakness;  signs and symptoms include dizziness w/heavy sensation, fullness of the chest or epigastric region, nausea, vomit, profuse sputum, no appetite. Greasy tongue w yellow or white coat and slippery pulse. Treatment points may include ren12, st40, st8, ub20, ub21, du20 Deficient conditions:  1. Qi and blood deficiency- arising from long term illness or st/sp weakness.  Signs and symptoms are dizziness worse with exertion, pale or dull complexion, lassitude, palpitations, insomnia, poor appetite, pale tongue, thin, weak pulse. Treatment points include, st36, sp6, ren6, ub20, ub17, du20 2. KD Jing deficiency- arising from old age or extreme exhaustion.  Signs and symptoms are chronic dizziness with empty feeling in the head, poor memory, tinnitus, sore low back and/or knees, red tongue, thin pulse. Treatment points include kd3, ren4, ub23, gb39, du20  Emperical points to be considered: Kd3, si1, si17, st8,st9,st40, st41, ub5, ub8, ub10 Tom Ren healing points: C1 huatuo, c2 huatuo, gb20, ub9, du20, gb12, sj16, L3 huatuo, yintang, taiyang, lv3   

Which Chinese herbal formulas can be helpful ?  

 TCM Formulas for Vertigo Causes 1. HYPERACTIVITY OF THE LIVER’S QI Treatment: Clear the Liver’s Yang, and smooth out the Liver’s Qi TCM formula: Tian ma gou teng tang (天麻钩藤汤) 2. DEFICIENCY OF QI AND BLOOD Treatment: Enrich the Qi and blood TCM formula: Gui pi tang (归脾汤) 3. DEFICIENCY OF KIDNEY YIN Treatment: Enrich and nourish the Kidney Yin TCM formula: Liu wei di huang wan (六味地黄丸) or zuo gui wan (左归丸) 4. EXCESSIVE PHLEGM AND DAMPNESS IN THE SPLEEN Treatment: Clear the phlegm and dampness, and strengthen the spleen TCM formula: Ban xie bai zhu tian ma tang (半夏白术天麻汤) 5. BLOOD STASIS Treatment: Promote blood circulation TCM formula: Tong qiao huo xie tang (通窍活血汤)  Evidence found in this case study - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4459064/