Dr. Tianlong Du's Blogs on Acupuncture and Chinese Medicine

Mal de Debarquent Syndrome ( MdDS ) is an illusory, persistent sensation of motion that occurs most commonly after a boat cruise or airplane flaght. Many people often experience this sensantion temporarily after disembarking, but in the case of MdDS sufferers it can persist for months or even years in some people.

The symptoms are usually most pronounced when the patient is sitting still, in fact, the sensation is usually minimized by actual motion such like walking or driving. MdDS is often more commonly referred to as Disembarkment Syndrome. The first reference to the syndrome was made by Erasmus Darwin, in 1796.

The symptoms most frequently reported include a persistent sensation of motion usually described as rocking, swaying, or bobbing;difficulty maintaining balance; extreme fatigue and difficulty concentration. Other common symptoms include dizziness, visual disturbance, headache or migraine, confusion and anxiety. Many patients also describe ear symptoms such as hyperacusis and tinnitus.

Epidemiology:These trends have recently been confirmed by the MdDS Balance Disorder Foundation in a study of over 100 individuals diagnosed with MdDS. The female:male ratio was approximately 9:1; the average age of onset was 43-45 years.

Diagnosis: MdDS is a diagnosis of exclusion. There are an no definitive tests that confirm MdDS, only tests that rule out other conditions such as Meniere’s disease and benign paroxyamal positional vertigo. Lab teses: normal range of audiagram, vestibular function and electronystagmogram; brain MRI was normal.

Unfortunately, There is no ” cure ” for MdDS. There are some suggested treatments, however, these is a relatively low succes rate. Some of these treatments include: walking while watching the horizon; vestibular therapy; Tricyclic antidepressants; and Benzodiazepines.

Case: A 38-years-old female visited our clinic on June 22, 2005 due to sensation of swaying for two and half years. The patient was took a cruise trip with her family for few days. After getting off the cruise, she started having the symptoms of persisting swaying; difficulty concentration; fatigue and headache. The symptoms were aggravated by strss, walking some distance, and insufficient sleep. When the patient drove a car, the sensation of swaying was alleviated noticeable. The patient cannot go to work. Neurological exam: negative. Brain MRI; brain and neck MRA, MRV; audiogram; and electronystagmogram was normal. Chinese medical exam: taut pulse; light white of tongue coating.

Treatment:
1. Acupuncture: Baihui point (GV20), Yintang point (EX-HN3), Yifeng point (TE17), Waiguan point (TE5), Zusanli point (ST36), Fenglong point (ST40), Sanyinjiao point (SP6) and Taichong point (LR3);
2. Scalp acupuncture;
3. Tapping acupuncture using plum needle for back of bladder maridian;
4. Auricular taping using seeds of vaccaria for points of Shenman, inner ear and brain.

Result of treatment: The treatments were given once a week for 18 times (weeks). The sensation of swaying and other symptoms almost disappeared.

Brachioradial pruritus is a neurogenic itch syndrome. It affects the areas of the upper arm and forearm with presumptive dermatomal distribution of cervical spinal nerves C5-C6. The itch of brachioradial pruritus is described as intense, burning and pricking. The discomfort is typically worse at night, for some patient, may interfere with falling asleep. Exposure of the affected areas to sun and wind may precipitate an episode, as may radiculopathy of the cervical spine. Despite the severity of symptoms, no associated erythema or skin eruption is seen. Evidence of excoriation or lichenfication may be present in the affected areas. Walsman first described the symptoms in Florida in 1968.

I have treated brachioradial pruritus successfully with acupuncture.

Case 1: The patient’s first visit was on Oct. 29, 2009. She was a 58 year-old female, complained of intense burning and itching on lateral upper arm and forearm of left side for 5 years. The symptoms began on forearm and later spread to upper arm. The symptoms gradually became more frequent and it was markedly accentuated by arm movement or arm touching other object. Physical exam showed nothing abnormal.

Case 2: The patient’s first visit was on July 30,2011. She was 49 year-old female, complained of intense pruritus of lateral upper arm and forearm. The itching was limited to one side of extremitis. The pruritus would come on suddenly and last approximately one hour. It occurred 2-3 times a week. Physical exam: hypersthesia in innervation of cervical spinal nerve C5-C6 of both upper extremities.

Therapeutic methods: apply acupuncture needles to the following acupoints:
1. main points: Jiaji  points at both C5 and C6;
2. supplementary points: from lung meridians hand-taiyin, with electro-acupuncture.

Therapeutic effect:
after treatment ( 5 times for case 1; 4 times for case 2 ), the clinical symptoms disappeared.

Sciatica definition:A syndrome characterized as a painful sensation from back to buttock and into lower extremity along its posterior or lateral aspect. Sciatica is most commonly caused by prolapse of the intervertebral disc. The term is also used to refer to pain anywhere along the course of the sciatic nerve.

Piriformis syndrome is a nerve condition in which the piriformis muscle irritates the sciatic nerve, pudendal nerve and posterior femoral cutaneous nerve, causing pain in the buttocks and referring pain along the cource of the sciatic nerve and other nerve.

Anatomically, the piriformis muscle lies deep to the gluteal muscle. It originates from the sacral spine and attaches to the upper border of greater trochanter of the femur. And the piriformis muscle and sciatic nerve cross each other behind the hip joint. The sciatic nerve passes underneath the piriformis muscle. In a small number of people the sciatic nerve actually passes directly through this muscle.

Cause of disease:
Trauma or strain of piriformis muscle; Inflammation- pelvic inflammation, peritonitis, sacroititis can spred over the piriformis muscle.

Common signs and symptoms:
The deep pain in the buttocks which is made worse by sitting on a car seat, running, climbing stairs , or performing squats; The pain can radiate into the regio femeris posterior, lateral surface of leg; Sometimes the pain can radiate into posterolateral thigh or perineum; Some severe case can have heaviness or fatigue at the leg.

Diagnosis and Identification diagnosis:
Piriformis syndrome can be very difficult to diagnose, and oftentimes is missed because it shares very similar symptoms with other conditions. For this reason the correct diagnosis for your pain may not be found right way. Listed some physical exam that may help to diagnosis of piriformis syndrome. Such as deep tenderness at the projection area of piriformis muscle; Positive of tonic test of piriformis muscle. X-ray, CT scan, MRI or nerve conduction test may necessary to exclude the lumbar disc herniation, impair or semis-dislocation of sacroiliac joint.

Treatment:
1. Acupuncture: Acupuncture points- Huantiao point (GB30), Yanglingquan point (GB34) and Xuanzhong point ( GB39). the patints with piriformis syndrome have their pain distributed along the Gall-bladder maridian of Foot-Shaoyang. Acupucture on this meridian, which is full of qi, but with little blood, is easy to induce a strong needling sensation. The GB30 point ( passing through the inferior edge of the piriformis muscle ), GB34 point ( Jinhui, one of eight confluence point ) with  GB39 points are located the Gall-bladder maridian. The result of acupuncture can direct target focus of piriformis muscule. Ashi points- Achi points located at projection area of piriformis muscle. We performed acupuncture with GB30, GB34, GB39 and Ashi points that can fast resolve the muscle’s edema, spasm and inflammation, then the pain can reduce or relieve.

2. Tui Na- Tui Na can help to relieve spasm, to improve local circulation, to alleviate inflammation.

3. Chinese herbs- Selecting herb formula to relieve pain.

Over the years, We have treated over 30 cases of piriformis syndrome. Most of the cases got satisfactory results.

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I have extensive knowledge and 46 years clinical experience using traditional Chinese medicine combined with western medicine in neurology and rehabilitation to serve patients.

I have been practicing Acupuncture and alternative medicine in Atlanta GA area for the past 10 years. During this time, I have treated all sorts of illness in our clinic. This invaluable experience has given me the chance to gain deeper understanding of the way human bodies function. It also provided me first hand knowledge on how to apply acupuncture and alternative medicines to treat or cure difficult ailments.

In my blogs, I’d explain the inner workings of acupuncture, moxibustion, traditional Chinese medicine theories, accupressure, cupping, Tui Na and other natural holistic remedies.

You will find general description and explanation of how acupuncture and Chinese medicine work, case studies, essays on diagnosis process, how a treatment protocol is selected, how the protocol is adjusted along based on a patient’s response to it.

I hope you will find useful information in my blogs. If you are in Atlanta GA area and thinking to give acupuncture a try, please stop by our clinic in Roswell.