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Condition Treated / Pain Conditions

Bell"s Palsy (Facial Paralysis)

Bell"s Palsy (Facial paralysis), also called "deviation of the mouth and eyes", is a disease that is mainly manifested as a deviation of the mouth and incomplete closure of the eyes. It may occur in patients of any ages during any season. It generally occurs suddenly, usually on one side of the face.

Bell's palsy is peripheral facial palsy in western medicine. Bell's palsy is a paralysis or weakness of the muscles on one side of your face. Damage to the facial nerve that controls muscles on one side of the face causes that side of your face to droop. The nerve damage may also affect your sense of taste and how you make tears and saliva. This condition comes on suddenly, often overnight, and usually gets better on its own within a few weeks. Bell's palsy is not the result of a stroke or a transient ischemic attack (TIA). While stroke and TIA can cause facial paralysis, there is no link between Bell's palsy and either of these conditions. But sudden weakness that occurs on one side of your face should be checked by a doctor right away to rule out these more serious causes.

Causes and Pathogenesis of the Bell's palsy

All yang channels travel up to the head and face. When the defensive qi is insufficient due
to over-exertion or the healthy qi is weak, the external wind may invade the channels and
collaterals of the face and affect the nutrition of the tendons and vessels, resulting in facial
paralysis.

Identification of Patterns

Chief symptoms Unilateral facial weakness, numbness and paralysis, disappearance of wrinkles,
enlarged rima oculi, exposure of the sclera, lacrimation, flattened nasolabial groove, and drooping
mouth-angle with deviation to the healthy side. The affected side is unable to frown, to raise the
eyebrow, to close the eyes, to show the teeth, and to expand the cheeks. For some patients in the
beginning of the episode, there may be pain behind the ear, hyperacousia and a taste deficiency in
the front 2/3 of the tongue on the affected side.

Wind-cold pattern is often seen in the early stage of onset. It may be accompanied by a light-colored tongue with a thin white coating and a floating, tight pulse and with a history of cold affecting the face.

Wind-heat pattern is often seen in the early stage of onset too, it may be accompanied by fever, dry throat, red tongue with a thin yellow coating and a floating, rapid pulse.

Qi-blood deficiency pattern is often seen in the convalescent stage or in patients with a prolonged course of the disease, it may be accompanied by lassitude, pale complexion, vertigo, pale tongue with a white coating and a thready, weak pulse.

Treatment

(1) Primary treatment

Principal points Yangbai (GB 14), Sibai (ST 2), Taiyang (EX-HN5), Jiache (ST 6), Dicang (ST 4), Hegu (LI 4), and Taichong (LR 3).
Supplementary points Add Fengchi (GB 20) to the pattern of wind-cold; add Quchi (LI 11) to the
pattern of wind-heat; add Zusanli (ST 36) to the convalescent stage; add Cuanzhu (BL 2) and Yuyao (EX-HN4) if the patient has difficulty in raising an eyebrow; add Yifeng (TE 17) in case of
pain at the mastoid region; add Shuigou (GV 26) and Chengjiang (CV 24) in case of deviation of the mentolabial groove; and add Yingxiang (LI 20) in case of a flattened nasolabial groove.
Explanation Yangbai (GB 14), Sibai (ST 2), Taiyang (EX-HN5), Jiache (ST 6), Dicang (ST 4) and other points of the face are selected to dredge and regulate qi and blood of the local tendons and collaterals, and to promote blood circulation for removing collateral obstruction. In the acute stage, Hegu (LI 4) and Taichong (LR 3) are selected from the remote parts found along the channels, and are needled with reducing manipulation to dispel wind and dredge the collaterals. In the onvalescent stage, Zusanli (ST 36) is added with reinforcing manipulation to supplement qi and blood, and nourish muscles and tendons.

(2) Alternate methods of treatment

Skin needle therapy Tap Yangbai (GB 14), Quanliao (SI 18), Dicang (ST 4) and Jiache (ST 6) with
the skin needle until the regional area is flushed. It is recommended to repeat this treatment every 1 or 2 days. This method is suitable for facial paralysis in the convalescent stage. Bloodletting and cupping Prick Yangbai (GB 14), Quanliao (SI 18), Dicang (ST 4) and Jiache (ST 6) with a three-edged needle, and then place cups on the points for bloodletting. It is recommended to repeat this twice a week. This method is suitable for facial paralysis in the convalescent stage.
External point-application Taiyang (EX-HN5), Yangbai (GB 14), Quanliao (SI 18), Dicang (ST 4) and Jiache (ST 6) are common points selected for external application. Place 0.3 to 0.6g of ma qian zi (Semen Strychni) powder on a piece of coated fabric, and then apply it on the point. Replace it every 5-7 days. Also, mash some castor beans into a paste, add a small amount of she xiang (Musk) into it, and apply a piece of the paste the size of a mung bean onto that point covered with the piece of coated fabric. Replace it every 3 to 5 days. Another method is to grind bai fu zi (Rhizoma Typhonii) into a powder and add a small amount of bing pian (Broneolum Syntheticum) into it, and apply some of the powder onto each of the points and cover them with a piece of coated fabric, replacing them daily. These methods are suitable for facial paralysis in later stages or persistent facial paralysis.

Remarks

Acupuncture is the first choice in the clinic for the treatment of facial paralysis and it usually
has excellent clinical outcomes. In the acute stage, it is advisable to treat using fewer points
and use a gentle manipulation, combining the therapies with moxibustion in the wind-cold pattern.
The electro-acupuncture should be avoided in this stage. Some of the patients, with a prolonged
course of the disease, may have atrophy of the affected facial muscles, in which the mouth deviates to the affected side, with facial muscular spasms.

The prognosis for facial paralysis is closely related to the degree of damage to the facial nerve.
Generally speaking, facial paralysis caused by aseptic inflammation and has a good prognosis, while that caused by a virus such as Hunter's facial palsy has a poor prognosis. If the patient has not recovered within 3 to 6 months, there may be permanent damage in most situations.

During the treatment period, patients should wear a mask and eye protection and avoid exposure to wind and cold. For patients who cannot close their eyes completely, eye drops should be administered 2 to 3 times per day to prevent infection.

Pain Care Acupuncture Clinic is your local acupuncture office in Torrance, CA . specializing in treating injuries and chronic pain. Dr. Ming Chen and Dr. Lu Yang, Both acupuncturists who also the oriental medical doctor ( O.M.D. ) can pinpoint the cause of the injury and suggest the best treatment methods for you. You need our doctor to listen to the whole story and examine you, so that you can get started treating on your injuries or chronic pain and get you on the track toward recovery.

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