I linked your case to this question you asked in the forum. Normally we have people 'Ask a Case Question' first (using the above link) and put their question in the forum, rather than in the case notes.
Regarding your case, it sounds like a tough one. Some things I think I've noticed in managing my own DM cases that may help, assuming anything can be done to help:
- I've found the usual back tonics like Du Huo Ji Sheng Tang and You Gui Wan can actually make cases worse. I think it's because the goal in DM is to keep spinal nitric oxide levels low. Even though these mainly work on the spinal column, there may be a spillover effect to the cord itself, at which point they can conceivably worsen DM. High nitric oxide levels induce further formation of the mutant SOD-1 enzyme, which then further clogs axons, hampering their function
- Physiotherapy is crucial in these cases, including gentle spinal manipulation and use of Assissi loops. Phototherapy is being explored as well, but needs to be used with caution, favouring settings that lower nitric oxide levels
- Real food diets are very important, since they will help lower metabolism and the rate of NO formation in the body in general, including the cord
- Physio efforts should center around the caudal thoracics, since that is almost invariably where the cord injury is that is propagating the oxidative stress that is aggravating the DM
- I use granular extracts of Minor Bupleurum rather than tablets, since they seem to pack a lot more punch
- Turmeric is potentially helpful, such as in Xiao Huo Luo Dan. However, I would institute the above first. The same comment applies to Bu Zhong Yi Qi Tang
- Use other tonics with great caution or not at all, remembering that the lag time between herbal formula change and an impact on the case in DM is generally about two weeks
Hopefully this helps you out!