Case Study: Recovery Stage of Hemorrhagic Stroke with Hemiplegia
A 76 year-old retired teacher visited the clinic 5 weeks after suffering a stroke. His chief complaint was weakness and paralysis of his left upper and lower extremities, but he also suffered from hypertension and had been on medication for over 20 years.
At the time of the initial consultation, he could stand on his right leg for a short period of time but he could not walk. He could not actively move his left arm and leg, and they were hypotonic. He had lost the ability to perform many of his daily activities, such as bathing himself and going to the washroom. Although he was able to manoeuvre around in a wheelchair and eat by himself, his energy level was low.
His appetite and bowel function was poor, he felt generally cold and his feet got cold easily. He reported having a lot of thin mucous in the morning especially when he just awoke. His tongue was pale and dark with thick whitish and greasy coating, and his pulse was weak.
The Western diagnosis was hemorrhagic stroke with hemiplegia, and the TCM diagnosis was “yang qi deficiency syndrome” combined with “phlegm and blood stasis syndrome”. He was treated with Chinese herbs and acupuncture to strengthen his yang qi in order to remove the phlegm and blood stasis.
The first 10 days of treatment consisted of 3 acupuncture treatments, combined with Chinese herbal medicine. Acupuncture points used were scalp motor and sensory areas, ST-36, SP-6, SP-9, GB-40, Shenguan, LI-11, LI-10 and LI-4. After 10 days, he was able to move his left shoulder a little bit, and his appetite and energy levels had increased. After two and a half weeks and 5 acupuncture treatments, he could actively move his hip.
We continued to see progress with acupuncture and herbal medicine treatment. He was treated for another 8 weeks at a treatment frequency of twice per week. After 16 treatments combined with muscle strength training, he was able to walk with a walker. He was also strong enough to go to the washroom and take a bath by himself. Although he could no longer drive by himself, he was able to perform daily living requirements without assistance
Case Study: Recovery Stage of Ischemic Stroke with Slurred Speech and Shoulder Hand Syndrome
A 46 year-old female housekeeper with a history of ischemic stroke came to the clinic for treatment of what had been diagnosed as “shoulder hand syndrome”. The patient had recovered quite well from the stroke that had occurred 3 months previously, with only minor slurred speech and mild dizziness. However, one week prior to treatment she began to feel pain over her right hand, which was followed by swelling. The pain became sharp, making it too painful to sleep or use the hand. She went to hospital and the doctor diagnosed her with reflex sympathetic dystrophy syndrome which is more commonly known as “shoulder hand syndrome”. Although the etiology in her case was not clear, in some cases it can be a complication of a stroke. She came to the clinic for help because she did not want to use steroids, as had been recommended by her medical doctor.
On physical examination her right hand was found to be swollen with a slightly dark yet pale color. Her pulses were little bit weak and slippery, especially on the right side. From a TCM point of view, her signs and symptoms corresponded to “dampness” blocking the meridians of her right hand, and acupuncture treatments were recommended.
The acupuncture treatments were designed to remove the dampness and unblock the meridians. Additionally, some acupuncture points over her neck were selected and stimulated to help improve her slurred speech and dizziness. After two acupuncture treatments, using scalp points (motor, sensory and speech areas), Linggu, Dabai, LI 11, LI 4 and SJ 5, the pain and the swelling had decreased significantly and her sleep was no longer disturbed by the pain of her hand. After three weeks and a total of five treatments, her right hand had returned to normal, but she still suffered from slurred speech and dizziness so we continued with acupuncture treatments. After six weeks and 10 acupuncture treatments, her dizziness was gone and she was able to speak with much more clarity which improved her communication with others.
Case Study: Recovery Stage of Ischemic Stroke with impaired sensory and motor function
A 45 year- old woman was partially paralyzed, and sensation impaired on her left side following an ischemic stroke. She had also been diagnosed with diabetes, but her blood sugar levels were poorly controlled, and she suffered frequent migraines with vomiting as well.
She began receiving acupuncture treatments four months after the stroke. At that time she was also receiving physical, occupational, and speech therapy. We selected scalp points (motor and sensory areas), ST 36, SP 6, SP 9, GB 40, LIV 3, LI 11, LI 4, SJ 4 and SJ 5. She received 16 acupuncture treatments over the next seven weeks as part of her rehabilitation program. Treatments were 3 times per week for the first two weeks, and twice per week for the next 5 weeks. Following this initial course of treatment, she had regained some sensation and motor function in the affected arm, wrist, and leg, and was able to walk without a brace. Additionally, the acupuncture helped to resolve her headaches and stabilized her blood sugar levels.
Case Study: Sequela Stage of Ischemic Stroke with Contracture
A 56-year-old fisherman visited the clinic for hip pain with limited range of motion. A physical examination was performed, and it was determined that the hip pain was due to muscle spasm, and the limited range of motion was due to contracture. Both were secondary symptoms of a stroke suffered seven years previously.
All the signs and symptoms pointed to the TCM syndrome of “qi deficiency combined with blood stasis”. In other words, the blood circulation was hindered due to a weakness in the vital energy “qi”. Simply put, there was not enough qi to properly move the blood. Acupuncture was administered to strengthen the qi and thereby remove the blood stasis.
After only two sessions of acupuncture his hip pain was gone, but the range of motion was still limited. Stretching exercises were recommended to lengthen the muscles that had shortened during immobilization. In addition, acupuncture and Chinese herbs were prescribed to help improve the blood circulation to promote swifter recovery. After six weeks of twice weekly treatments (12 treatments in total), his contracture was 50% better and the blood circulation of the whole body was improved. Other signs such as rigid muscle tonicity and spasticity, were still present, but he was able to walk better and perform daily activities without assistance. He felt that he and his family’s quality of life were greatly improved.
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