On three occasions this past year I have seen clinical presentations of Facial Paralysis. Each time, the patient arrived having a western medical diagnosis of "Bell's Palsy". Chinese Medicine views Facial Paralysis as an invasion of Wind Cold disrupting the Qi and Blood of the channels. The treatment plan is to Disperse Qi and expel Wind.
The first case was in the later stages of the condition with the patient suffering from: significant loss of facial continuity (droop), diminished sensitivity to a majority of the left side, diminished ability to taste, and excessive tearing. The clinical goal in this case was to attempt to reverse the symptoms of the condition through acupuncture, electro-acupuncture, and moxibustion.
Both the second and third cases arrived very soon after diagnosis (within 72hrs) and both manifested similarly with: dull occipital headache, mild tinnitus, mild loss of facial continuity. One case reported a sense of dizzyness or lack of balance. The clinical goal in these cases was to eliminate wind and disperse the qi of the channels coursing the head and face (Primarily Gall Bladder and Stomach).
Acupuncture point selection for these cases was very similar regardless of the stage or symptoms presenting. My preference for needling pathogenic wind cases is a very shallow insertion on the head and face with empirical depths on the distal points.
Primary Acu-Points Chosen:
The first case was in the later stages of the condition with the patient suffering from: significant loss of facial continuity (droop), diminished sensitivity to a majority of the left side, diminished ability to taste, and excessive tearing. The clinical goal in this case was to attempt to reverse the symptoms of the condition through acupuncture, electro-acupuncture, and moxibustion.
Both the second and third cases arrived very soon after diagnosis (within 72hrs) and both manifested similarly with: dull occipital headache, mild tinnitus, mild loss of facial continuity. One case reported a sense of dizzyness or lack of balance. The clinical goal in these cases was to eliminate wind and disperse the qi of the channels coursing the head and face (Primarily Gall Bladder and Stomach).
Acupuncture point selection for these cases was very similar regardless of the stage or symptoms presenting. My preference for needling pathogenic wind cases is a very shallow insertion on the head and face with empirical depths on the distal points.
Primary Acu-Points Chosen:
- Gall Bladder 20 (Fengchi)
- Gall Bladder 14 (Yangbai)
- Stomach 4 (Dicang)
- Stomach 2 (Sibai)
- Large Intestine 4 (Hegu)
Secondary Acu-Points Chosen:
**Points on the head and face all needled Ipsilateral
For each of the three cases moxibustion was used via Tigertherm. This technique is designed to assist in dispelling cold and moving local qi and blood. In this application Tigertherm is used in two "routes". One route beginning at Stomach 3 and following the Stomach meridian to Stomach 8 and the second, sweeping the eyebrow from Urinary Bladder 2 across to extra-point Taiyang. I begin this technique on the unaffected side so the patient can feel the proper sensation and so I can gauge the warmth of the Tigertherm. Caution is used on the affected side due to loss of sensitivity; for which I use a lighter, faster technique.
Sessions for the acute cases were twice per week for three weeks. Sessions for the chronic case was twice the first week and once per week for the following four weeks. Acupuncture was always performed with other modalities incorporated accordingly.
The results of these treatments were all noticeably positive, all within six visits. In the acute cases, both reported no occipital headache and facial continuity perceived as 'normal' within the first four treatments. In a report of findings following the sixth treatment, the case with the dizzyness/lack of balance reported lower frequency and intensity of this sensation. The tinnitus remained relatively unchanged in this case. The second case reported improvement of the tinnitus to only occasional and very light.
The chronic case noticed an improvement of sensation and movement of the mouth and cheek within the first three treatments. With improved sensation the perceived facial continuity also improved. Within the first six treatments improvement was also made with the excessive tearing. The tearing was initially persistent throughout the day. Improvement in this case was: occasional tearing in the morning, easy to tear during the day, and less tearing over night. Results relating to loss of taste were inconclusive. The patient reported that she thought she could taste some things more than others but with no definitive way to measure, this change is considered negligible.
There are many factors that go into treating any patient. As such, results are often inconsistent. This approach may work very well in most cases and not at all in others. The beauty of Traditional Chinese Medicine is that you have many modalities at your disposal.
If you have any questions I am always available for a free 15-minute consult. Call or come by our downtown location at Accelerate Health~ Mike Allen, L.Ac.
- DU 20
- Stomach 6 (Jiache)
- Stomach 36 (Zusanli)
- Stomach 44 (Neiting)
**Points on the head and face all needled Ipsilateral
For the more chronic case electro-acupuncture was used. Selection of points for this method can vary depending on practitioner style and patient tolerance. For this case leads were attached to Stomach 6 and Large Intestine 4 at 7Hz for a duration of 20 minutes. Electro-acupuncture is not typically employed during the acute stages of Facial Paralysis (Bell's Palsy). Electro-acupuncture should always be used cautiously on the head and face. If the patient does not have a western medical diagnosis of Bell's Palsy and presents with facial paralysis I will refer them to their primary care physician immediately to rule out any cerebro-vascular possibilities.
For each of the three cases moxibustion was used via Tigertherm. This technique is designed to assist in dispelling cold and moving local qi and blood. In this application Tigertherm is used in two "routes". One route beginning at Stomach 3 and following the Stomach meridian to Stomach 8 and the second, sweeping the eyebrow from Urinary Bladder 2 across to extra-point Taiyang. I begin this technique on the unaffected side so the patient can feel the proper sensation and so I can gauge the warmth of the Tigertherm. Caution is used on the affected side due to loss of sensitivity; for which I use a lighter, faster technique.
Sessions for the acute cases were twice per week for three weeks. Sessions for the chronic case was twice the first week and once per week for the following four weeks. Acupuncture was always performed with other modalities incorporated accordingly.
The results of these treatments were all noticeably positive, all within six visits. In the acute cases, both reported no occipital headache and facial continuity perceived as 'normal' within the first four treatments. In a report of findings following the sixth treatment, the case with the dizzyness/lack of balance reported lower frequency and intensity of this sensation. The tinnitus remained relatively unchanged in this case. The second case reported improvement of the tinnitus to only occasional and very light.
The chronic case noticed an improvement of sensation and movement of the mouth and cheek within the first three treatments. With improved sensation the perceived facial continuity also improved. Within the first six treatments improvement was also made with the excessive tearing. The tearing was initially persistent throughout the day. Improvement in this case was: occasional tearing in the morning, easy to tear during the day, and less tearing over night. Results relating to loss of taste were inconclusive. The patient reported that she thought she could taste some things more than others but with no definitive way to measure, this change is considered negligible.
There are many factors that go into treating any patient. As such, results are often inconsistent. This approach may work very well in most cases and not at all in others. The beauty of Traditional Chinese Medicine is that you have many modalities at your disposal.
If you have any questions I am always available for a free 15-minute consult. Call or come by our downtown location at Accelerate Health~ Mike Allen, L.Ac.
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