Type 2: Blinking Dim Spots Type (Three syndromes in TCM)

It is caused by temporary blood vessel spasm of the brain and inner eyes. Insufficient supply of oxygen and blood in inner eyes causes visual illusions such as firework, irregular dim spots and etc. When the brain structure lacks of oxygen, mild and instantaneous excitement takes place, causing nausea, vomiting, headache and vertigo.

Main points of diagnosis

1.      Visual illusions: Visual firework, flashing light (as waving transparent light bulbs), water wave-like light pattern. Some patients may experience one-sided dim spots. A few seconds after the visual illusions disappear, migraine attacks.

2.      The nature of the headache is of the pounding one, most painful on the forehead, around the eyes and at temples. The head aches as if it is wrapped, accompanied with dizziness, nausea and vomiting. Typical cases last from a few minutes to a few hours. A few may last more than half a day.

3.      Recurring frequently is typical for this type of migraine. Some patients have more frequent attacks in the later stages, as well as its length of attack. The subsiding period, however, has no whatever symptoms at all.

4.      Further investigation indicates increases of cerebral blood vessel tension and dynamic frictions. For some patients who can have their inner eyes arteries seen, obvious pounding can be observed.

Treatments

It is important to avoid fatigue, emotional outbreaks and tensile anxiety. This is particularly true to avoid recurring. In differentiation of syndromes in TCM, there are three types. They are:

1.      Insufficiency of qi and deficiency of blood

2.      Accumulation of cold in the liver channel and qi stagnancy

3.      Stagnancy of the liver-qi

1. Insufficiency of qi and deficiency of blood

Clinical manifestations/Indications: Frequent headache and vertigo, tinnitus, insomnia, poor appetite, palpitation, shortness of breath, fatigue, fullness in abdomen, loose stool and etc. in common.

Therapeutic Principle: Replenishing qi, nourishing blood and tranquilizing the mind. 

Recipe: Modified (Decoction of Eight Jewels)*

Main Ingredients: Radix Codonopsis, Rhizoma Atractylodis Macrocephalae, Radix Polygalae, and Radix Angelicae Sinensis.

2. Accumulation of cold in the liver channel and qi stagnancy

Clinical manifestations/Indications: Symptoms seen are similar to Mono Type. Other than having obvious forebodings and headache, many patients suffer from deficiency and cold in the middle-jiao that is manifested by fullness in abdomen, aversion to cold and liking to warmth.

Therapeutic Principle: Warming liver channel by dispelling cold, eliminating dampness and promoting circulation of qi.

Recipe: Additive to Decoction of Evodia Fruit

Main Ingredients: Fructus Evodiae, Radix Ledebouriellae, Radix Angelicae Dahuricae, Rhizoma Cyperi, Rhizoma Ligustici Chuanxiong.

3. Stagnancy of the liver-qi

Clinical manifestations/Indications: Other than typical headache and symptoms around eyes, patients can be seen as having bad temper, frustration, or with dark purple tongue and fingers. This syndrome is rather rare.

Therapeutic Principle: Soothing the liver to disperse the depressed qi, promoting blood circulation and removing blood stasis.

Recipe: Modified Decoction of Evodia Fruit

Main Ingredients: Radix Paeoniae Rubra, Radix Salviae Miltiorrhizae, Radix Bupleuri, Flos Albiziae, Fructus Evodiae, Poria.