Facial paralysis
StarEssentials of Chinese Acupuncture (Beijing, Shanghai and Nanjing Colleges of Traditional Chinese Medicine, 1980) — the standard prescriptions of the Chinese colleges.
Points
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San Jiao point behind the ear lobe; dispels wind near the facial nerve's exit
Even method.
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Stomach point at the corner of the mouth; local Yangming point
Even method; may be threaded horizontally toward ST6.
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Stomach point at the angle of the jaw; local Yangming point
Even method.
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Gall Bladder point above the eyebrow; local point for the forehead
Even method.
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Extra point at the temple; local point for the upper face
Even method.
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Yuan-Source of the Large Intestine; distal Yangming point that clears wind from the face
Even method.
- Pregnancy: contraindicated
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Small Intestine point under the cheekbone; local point
Even method.
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Stomach point in front of the ear; local Yangming point
Even method.
Needling Safety
Cited hazards for these points. Tick what applies to the patient to see the cautions that follow from it.
No cited needling data yet for EX-HN5. No flag here does not mean no risk.
Treatment Principle
Expel wind and clear the facial collaterals with even method, working mainly through the Hand and Foot Yangming channels.
Indications
Method
Even method. Choose three to five points per session; through-needling, such as threading ST4 horizontally toward ST6, may be used. Treat daily in the early stage.
⚠ Cautions
Exclude stroke (forehead spared, limb weakness or speech change), Ramsay Hunt syndrome (vesicles in the ear), tumour and Lyme disease; early corticosteroids are the evidence-based treatment for Bell's palsy within 72 hours, so refer for medical assessment. Protect an eye that cannot close. LI4 is contraindicated in pregnancy. The eye-region add-on points (BL1, BL2, GB1, Yuyao) need shallow, careful needling; BL1 in particular carries a risk of orbital haemorrhage.
About
The textbook's prescription for peripheral facial paralysis caused by wind-cold or phlegm invading the channels of the face.
Rationale
Most of the points lie on the affected side of the face along the Yangming, Shaoyang and Taiyang channels, where they expel wind and get circulation moving locally. LI4 is the distal point; the book describes LI4 combined with LV3, the Yuan points of these two channels, as effective in clearing wind from the head and face.
Clinical Notes
Add-ons by symptom: headache, GB20; copious phlegm, ST40; difficulty frowning or raising the brow, BL2 and TE23; incomplete eye closure, BL2, BL1, GB1, Yuyao (EX-HN4) and TE23; difficulty sniffing, LI20; deviated philtrum, GV26; inability to show the teeth, ST3; tinnitus or deafness, GB2; twitching of eyelid and mouth, LV3; tenderness over the mastoid, GB12. The book identifies the condition with Bell's palsy (peripheral facial palsy). In long-standing cases it suggests warming needle or mild moxibustion at two or three of Taiyang, ST6, ST4, ST3 and ST7 for two to three minutes each, and small cups on the affected side every three to five days as an adjunct.
Sources
- Beijing College of Traditional Chinese Medicine, et al. Essentials of Chinese Acupuncture. Beijing: Foreign Languages Press, 1980. Chapter III, Facial paralysis, p. 340–342.
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