Acupuncture Continuing Education

Acupuncture Found Effective For Bell’s Palsy

facial acupoints

Acupuncture reverses facial paralysis due to Bell’s Palsy. Researchers from the General Hospital of People's Liberation Army (Beijing) compared two types of acupuncture for the treatment of infranuclear facial paralysis affecting the facial nerve (cranial nerve VII). One treatment protocol achieved a 98% total effective rate and the other acupuncture protocol achieved a 90.7% total effective rate. [1] Based on the data, acupuncture is recommended for the treatment of facial paralysis due to Bell’s Palsy. 

Infranuclear facial paralysis without a biomedically known etiology is often designated as Bell’s Palsy, which is distinct from infranuclear facial paralysis due to trauma, neoplasms, cerebrovascular infarctions, and facial paralysis that is secondary to diseases including diabetes, amyloidosis, and multiple sclerosis. The researchers note that modern Traditional Chinese Medicine (TCM) sources indicate that Bell’s Palsy involves inflammation of cranial nerve VII affecting regions of the stylomastoid foramen or the facial canal and ancient references indicate Yangming and Shaoyang channel obstruction. Guiding treatment principles are to dredge the channels, expel external pernicious influences, and to improve blood circulation. A macroscopic TCM view indicates that localized stimulation of facial muscles promotes recovery.

Scientists now posit that Bell’s Palsy involves neurodegeneration of neurons due to ischemia and edema, although many cases are not ascribed a known etiology. The researchers note that the work of Chen et al. helps to explain, in part, how acupuncture restores normal movement to facial muscles for patients with Bell’s Palsy and other forms of infranuclear facial paralysis. Chen et al. demonstrated that electroacupuncture has the ability to upregulate nerve growth factor, thereby restoring neurons. [2] The Healthcare Medicine Institute (HealthCMi) offers several courses related to nerve repair and restoration of functional mobility. For additional information beyond the scope of this article, visit HealthCMi’s acupuncture continuing education course on the topic of Bell’s Palsy:

 

Bell's Palsy Online CEU Course >

 

Acupuncture Treatment
Let’s take a look at the treatment protocols that achieved clinical success in the study. A total of 93 patients were randomized into two groups, each receiving different acupuncture protocols. The first treatment protocol, achieving a 98% total effective rate, is as follows. The focus was application of acupuncture to local acupoints related to facial expression muscles that were paralyzed. Acupuncture was applied to GB14 (Yangbai) and acupoints within 3 cm. Acupuncture was applied to the orbicularis oculi muscle region. Acupuncture was also applied to SI18 (Quanliao) and ST3 ( Juliao) at the zygomaticus major. The levator labii superioris was needled at EX-HN8 (Shang Yingxiang) and LI20 (Yingxiang). The orbicularis oris muscle was needled at Jiashuigou, MHN18 (Jiachengjiang), and ST4 (Dicang). The needles were inserted superficially and manipulated to enter the muscular layer.

Mild reinforcing and attenuating manipulation techniques were used to induce a deqi response. Next, the intensity of a pulsating electroacupuncture current was adjusted until facial muscles were slightly and rhythmically twitching. Only one group of facial muscles were stimulated at a time. The needle retention time was 20 minutes. ST7 (Xiaguan), GB20 (Fengchi), TB17 (Yifeng), and LI4 (Hegu) acupoints were perpendicularly inserted without connection to an electroacupuncture device.

The other group achieved a 90.7% total effective rate with the follow treatment protocol. Unilateral acupuncture was applied to the side affected, paralyzed side. Acupuncture was applied to the following acupoints:

  • GB14 (Yangbai)
  • MHN9 (Taiyang)
  • GB1 (Tongziliao)
  • ST6 (Jiache)
  • ST4 (Dicang)
  • SI18 (Quanliao)
  • Jiashuigou (0.5–1 cun lateral to Shuigou, GV26)
  • Jiachengjiang (1 cun lateral to Chengjiang, CV24)

For patients with acute mastoiditis pain, TB17 (Yifeng) and GB20 (Fengchi) were added. For patients with severe deviation of the mouth, ST7 (Xiaguan) and LI4 (Hegu) were added. After the arrival of deqi, electroacupuncture was applied with a disperse-dense wave. The electrical intensity was adjusted until slight and rhythmic facial muscle twitching was induced. The needle retention time was 20 minutes. Both groups received treatment once per day, five treatments to complete one course of treatment, with a 2-day break between each course of treatment. In total, the patients received eight courses of treatment. In the above research, both treatment protocols were effective, with the first protocol outperforming the second.

 

Acupuncture with Drug Therapy
In a related two week investigation, Third People’s Hospital (Chongqing) researchers (Wang et al.) conclude that acupuncture plus infrared heat therapy combined with medications significantly improves positive patient outcome rates for patients with facial paralysis. Patients receiving only medications had a 60.42% total effective rate. The addition of acupuncture and infrared therapy increased the effective rate to 91.67%. [3] The primary acupuncture points use in the study were the following:

  • Jiache (ST6)
  • Xiaguan (ST7)
  • Dicang (ST4)
  • Yifeng (TB17)
  • Taiyang (MHN9)
  • Zanzhu (BL2)
  • Hegu (LI4)
  • Fengchi (GB20)

The secondary acupoints selected were the following:

  • Yangbai (GB14)
  • Yingxiang (LI20)
  • Renzhong (GV26)
  • Sibai (ST2)
  • Chengjiang (REN24)

Acupuncture was administered once daily for 14 consecutive days. Infrared therapy was administered using an infrared light therapy device with a 640 nm wavelength emission. The paralysis side received infrared heat from a distance of 30–35 cm and the skin surface temperature was maintained at 40 degrees Celsius or to patient tolerance levels. The infrared heat therapy therapy was applied for 20 minutes, two times daily, for 14 consecutive days. The facial paralysis medications were as follows:

  • Dexamethasone. Intravenously injected, once daily, for 10 consecutive days.
  • Vitamin B12 (0.5 mg), Vitamin B1 (100 mg). Administered through muscle injection, once daily, continuously for 14 consecutive days.
  • Brain glycoside injection fluid (3 ml). Administered through muscle injection, 2 times daily, for 14 consecutive days.
  • In cases of viral infections, the patient was given acyclovir tablets (0.4 g), taken orally 3 times daily, for 10 consecutive days.

The researchers obtained a 31.25% increase in total treatment efficacy by adding acupuncture and infrared therapy to the medication therapy protocol. In all cases mentioned in this article, patients responded with improved patient outcomes for recovery from facial paralysis. As a result, the researchers from these studies conclude that acupuncture is an appropriate treatment option for patients with facial paralysis.

 

Notes:
1. Jiang YB, Feng Y. (2014). Therapeutic Effect of Special Acupuncture in the Treatment of Facial Paralysis. JCAM. 30(1).

2. Chen YC, Qi WL & Kong KM. (2006). Rat Acute Spinal Cord Injury: the Effect of Electroacupuncture on the Level of Nerve Growth Factor and Its Receptor. Chinese Journal of Clinical Rehabilitation. 10(11): 129-131.

3. Wang, X., Jin, T. & Ma, S. L. (2014). Red glow with acupuncture and medication curative effect observation of 96 cases of facial paralysis. Laser Journal. 35 (2).

 

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