bubble_chart Concept

Acute convulsion, also known as "acute infantile convulsion," or referred to as "convulsion," commonly known as "wind seizure."

"Infantile convulsion" was first recorded in the Song Dynasty Taiping Shenghui Fang , after which, Xiao'er Yaozheng Zhijue differentiated acute infantile convulsion into two syndromes: acute and chronic. Acute convulsion is mostly attributed to yang heat excess pattern, while chronic convulsion is mostly attributed to deficiency pattern or a combination of deficiency and excess, and there is a theory that acute convulsion can turn into chronic convulsion.

The symptoms of acute convulsion include twitching, clenching, pulling, trembling, arching, stretching, darting, and staring, collectively referred to as the "eight signs of infantile convulsion." Twitching refers to the extension and contraction of the arms; clenching refers to the opening and closing of the fingers; pulling refers to the shoulders thrusting forward; trembling refers to the shaking of the hands and feet; arching refers to leaning backward; stretching refers to the hands as if drawing a bow; darting refers to the eyes rolling upward; and staring refers to the eyes being fixed without moving. This is a summary of the symptoms of infantile convulsion by predecessors.

bubble_chart Pattern Analysis

1. External Contraction︰Convulsion, fever without sweating, headache, cough, runny nose, red throat, dysphoria and restlessness, white tongue coating, and floating rapid pulse. This is due to the delicate skin of children, loose striae and interstices, exposure to external pathogens that transform into heat internally. Excessive heat generates phlegm, which accumulates in the lung and stomach, stagnates and transforms into fire. Intense fire stirs wind, leading to acute convulsions. Hence, the onset is sudden, convulsions are severe, accompanied by fever without sweating, headache, cough, runny nose, red throat, thin white tongue coating, and floating rapid pulse. Treatment involves dispersing wind and clearing heat, extinguishing wind and resolving phlegm. Prescriptions used include Heat-Clearing and Fright-Calming Decoction, and Cow-Bezoar Thousand Gold Pieces Powder.
2. Summer-heat︰unconsciousness convulsion，high fever headache，thirst spontaneous sweating，vomiting neck stiffness，red crimson tongue，thin yellow greasy coating，wiry rapid pulse。Due to constitutional deficiency of qi and yin，affected by summerheat，scorching qi and nutrient aspects，heat sinking into jueyin，internal blockage of {|###|}mental activity{|###|} manifesting as infantile convulsion。The disease occurs in summer，manifesting as high fever，unconsciousness，convulsions，red crimson tongue，wiry rapid pulse。Treatment aims at {|###|}clearing nutrient aspect{|###|} draining heat，{|###|}orifice-opening extinguishing wind{|###|}。The formula uses Nutrient-Clearing Decoction plus moutan bark，uncaria，antelope horn，Peaceful Palace Bovine Bezoar Pill，or Purple Snow Bolus。
3. Hot Phlegm︰Sudden convulsion, body heat and flushed face, dysphoria and thirst, coarse breathing with phlegm sounds, locked jaw, constipation and dysuria, red tongue texture with thick yellow coating, wiry, slippery, and rapid pulse. This is caused by food stagnation generating phlegm, phlegm-heat obstructing the airway, and accumulation in the thorax, diaphragm, and intestines leading to sudden convulsion, coarse breathing with phlegm sounds, locked jaw, and thick yellow coating. Treatment should focus on {|###|}clearing heat and resolving phlegm{|###|}, {|###|}pacifying the liver and extinguishing wind{|###|}. The prescribed formulas are Antelope Horn and Uncaria Decoction and {|###|}Cow-Bezoar Dragon-Embracing Pill{|###|}.
4. Food Stagnation︰Pale complexion and convulsion, anorexia vomiting, abdominal distension and fullness with pain, constipation disease or sour and foul-smelling stools, sallow complexion and dull spirit, or phlegm sounds in the throat, tongue coating thick and yellow, pulse slippery, large, and rapid. This is caused by food stagnation failing to transform, congestion failing to disperse, stagnation transforming into heat, and stirring liver wind, leading to illness. The key points for clinical differentiation are: pale complexion and convulsion, accompanied by symptoms of food stagnation such as abdominal distension and fullness with distending pain, and sour and foul-smelling stools. Treatment should focus on promoting digestion and removing food stagnation, supplemented by calming fright. The recommended formulas are Harmony-Preserving Pill and Jade Pivot Elixir.
5. Fright︰There may be fever or low-grade fever, a bluish complexion, cold hands and feet, frequent fright and vigilance, restless sleep, or unconsciousness with intermittent startled crying, convulsions of the hands and feet, a thin white tongue coating, and bluish finger venules. Due to the weak spirit and insufficient original qi in infants, sudden exposure to strange objects or sounds, or accidental falls may cause sudden fright. Fright disrupts the spirit and qi, while fear damages the will and causes qi to sink, leading to disorder in qi, blood, yin, and yang, resulting in unsettled spirit and the onset of infantile convulsions. Symptoms include a bluish complexion, cold hands and feet, frequent trembling, fright and restlessness, a normal tongue coating, and bluish finger venules. Treatment involves calming the heart and mind, using remedies such as Milkwort Root Pill and Amber Dragon-Embracing Pill.

Infantile convulsion is a common critical condition in pediatrics, and clinically, certain symptoms and signs similar to infantile convulsion should be differentiated. For example, epilepsy: sudden fainting during an attack, foaming at the mouth during spasm, incontinence of urine and feces, and returning to normal consciousness after convulsions, occurring several times a day or once every few days. Neonatal tetanus: mostly occurs in newborns, generally within three days or beyond seven days, it does not belong to this condition. Infantile fright: attacks are mostly without fever, eyes do not roll up, and the pulse is not tense. Worm pattern: pain caused by worms, although there may be staring eyes, lockjaw without speaking, and cold hands and feet, but mostly without fever or spasm, mainly characterized by abdominal pain. Convulsions with uplifted eyes: mainly manifested as rolling eyes and looking upwards. Convulsions with visceral colic: characterized by visceral spasms and frequent crying due to abdominal pain. Convulsions with uplifted eyes are heat-related and belong to yang, while convulsions with visceral colic are cold-related and belong to yin. "You You Jin Bian" points out: "Convulsions with uplifted eyes are due to heart abdominal mass caused by lung disorder heat, and convulsions with visceral colic belong to deficiency-cold of spleen and stomach." Convulsions with uplifted eyes and convulsions with visceral colic are two special pattern types of infantile convulsion, both belonging to the category of infantile convulsion.

Precursors of infantile convulsion: although infantile convulsion is mainly characterized by convulsive spasms, there are many signs clinically that also belong to the precursors of wind movement or convulsions. Yilin Gaicuo states in "On Convulsions Not Being Wind": "Before convulsions are about to occur, the symptoms of convulsions must first appear." Common ones include: protruding tongue, tongue deviation, curled tongue and retracted testicles, mouth puckering, lockjaw, mouth deviation, inability to suckle, grinding of teeth, tight jaw, head shaking, neck stiffness, flaring nostrils, sleeping with eyes open, frightened eyes, restlessness, crying without tears, hair standing on end, blue face, blue fingerprints, blue root of nose, exposed blue veins at the taiyang point, and green stool. Others such as grasping at the air and floccillation are all signs of wind, these symptoms do not need to all appear, but seeing one or two is enough to indicate a wind pattern.

bubble_chart Documentation

1. Suwen-Daqi Lun: "The heart pulse is full and large, indicating epilepsy and muscular spasm; the liver pulse is small and rapid, indicating epilepsy and muscular spasm; the liver pulse is swift and violent, indicating fright and terror."
2. Xiao'er Yaozheng Zhijue: "In children, acute convulsions are fundamentally caused by heat generated in the heart, manifesting as body heat, red face, thirst, hot breath, dark urine, and in severe cases, convulsions. It is said that extreme heat generates wind, and wind is associated with the liver, indicating yang exuberance and yin deficiency."
3. Pediatrics Zhengzhi Zhunsheng．Convulsions: "The symptoms of acute convulsions, also known as true convulsions, include locked jaw, high fever, drooling, upward rolling of the eyes, arching of the back, convulsive trembling of the lips, frequent blinking of the eyes, cold breath, red face and lips, dark urine, and a floating, rapid, or floating and surging pulse. This is due to internal accumulation of real heat and external contraction of wind evil, with the heart accumulating heat and the liver generating wind to cause convulsions. The struggle between liver wind and heart fire in the two organs leads to chaotic blood and qi, phlegm and saliva congestion, stagnation of the hundred vessels, blockage of the orifices, and rampant wind qi with no outlet, hence the violent outbreak. There are also cases of convulsions with arching of the back and squinting, but without locked jaw or phlegm and saliva, and with hot breath, which should not be directly identified as infantile convulsions, as it may be a common cold, cold-damage disease, or other conditions with real and fright factors, as per Qian's theory of false convulsions, and should be treated according to the specific condition."
4. Youyou Jicheng．Great fright and sudden fear: "Zhang Jing-yue said, when a child is suddenly greatly frightened, it most harms the qi of the heart and gallbladder. Neijing-Kouwen chapter says, great fright and sudden fear cause the qi and blood to separate, yin and yang to scatter, the meridians to collapse, the pulse pathways to block, yin and yang to reverse, Jingmai to become empty, qi and blood to become disordered, and thus lose their normal state. This Neijing generally describes the disease of being frightened as such."