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[Introduction]
Peripheral facial paralysis is due to acute and non-suppurating inflammation in stylomastoid foramen, marked by sudden onset in the morning with the manifes-tations of stiffness, numbness and looseness of the face, enlargement of palpebral fissure, deviation of the mouth to the healthy side, disappearance of wrinkles on the fore-head, flattening of the nasolabial groove and inability to draw eyebrows, frown, close eyes, show teeth, bulge cheeks and pout lips. In some patients pain appears behind the ear and in the face in the early stage. It is similar to distortion of face in TCM. It is mainly caused by wind at-tacking the meridians in the face, leading to obstruction of meridian qi, malnutrition of tendons and flaccidity of mus-cles.
[Syndrome differentiation]
1. Wind attacking superficies
Sudden distortion of face, numbness of face, or pain behind the ear, aversion to cold and fever, thin and white
tongue fur, floating and tense or floating and rapid pulse.
2. Insufficiency of qi and blood as well as ob-struction of pathogenic factors in the vessels and meridians
Prolonged duration of illness, distortion of face, stiffness of face, even spasm of face, or difficulty in open-ing eyes, light-colored tongue and thin pulse.
[Treatment]
1. Body acupuncture
Prescription: Fengchi (GB 20), Jiache (ST 6), Di-cang (ST 4), Hegu (LI 4) and Taichong (LR 3).
Modification: For pain behind ear: Yifeng (TE 17) is added; for inability to close eyes, Yangbai (GB 14) and Cuanzhu (BL 2) are added; for flattening of nasolabial groove, Yingxiang (LI 20) is added; for deviation of na-solabial groove, Shuigou (GV 26) is added; for deviation of mentolabial groove, Chengjiang (CV 24) is added; for prolonged duration of illness, Zusanli (ST 36) is added.
Performance. Jiache (ST 6) and Dicang (ST 4) are needled horizontally toward each other; Yangbai (GB 14) is needled horizontally downward. The acupoints on the face are needled with mild reinforcing and reducing nee-dling techniques; Fengchi (GB 20) is needled with rota-ting and twirling techniques; Hegu (LI 4) and Taichong ( LR 3) are needled with reducing techniques; Zusanli (ST 36) is needled with reinforcing technique with the addition of moxibustion. The needling technique in the early stage should be mild.
2. Electro-acupuncture
Prescription: Jiache (ST 6), Dicang (ST 4), Yang-bai (GB 14) and Sibai (ST 2).
Performance: Electricity is attached to the needles for 10 minutes when the acupoints mentioned above are needled till needling sensation is felt. The frequency of stimulation is monitored to mild jerk of the facial muscles. The needling is done once a day or once every other day.
