Bell's Palsy (Acupuncture)
Acupuncture for Bell's Palsy
Bell's palsy is a form of facial paralysis resulting from damage to the VII
(facial) cranial nerve. This nerve disorder afflicts
approximately 40,000 Americans each year. It can strike almost anyone at any
age; however, it disproportionately attacks pregnant
women and people who have diabetes, influenza, a cold, or some other upper
respiratory ailment.
In addition to one-sided facial paralysis with possible inability to close the
eye, symptoms of Bell's palsy may include pain, tearing, drooling,
hypersensitivity to sound in the affected ear, and impairment of taste.
The common cold sore virus, herpes simplex virus (HSV), and other herpes viruses
are the likely cause of many cases of Bell's palsy.
HSV has been observed in saliva (Furuta, Fukuda et al. 1998) as well as muscle
biopsy and tears (Kaygusuz, Godekmerdan et al. 2004) of Bell's palsy patients at
significantly higher rates than control groups. One study found that
approximately 50% of Bell's palsy patients show signs of the virus compared to
approximately 19% of the normal population (Furuta, Fukuda et al. 1998).
However, an opposing trial found HSV as well as VZV to be non-significantly
represented in affected groups (Linder, Bossart et al. 2005). The life span of
the virus and the timing of testing for HSV may explain these conflicting
conclusions. Furuta (1998) discovered in his trial that HSV became undetectable
after two weeks onset of Bell's palsy. The evidence suggesting HSV as the major
cause of this condition is demonstrated further by the success of specific
antiviral agents which have shown continued success against HSV infections
(Adour, Ruboyianes et al. 1996; Allen and Dunn 2004; Allen and Dunn 2005).
Furthermore, injections into rat specimens with HSV have recreated facial
paralysis in approximate 50% of specimens (Gok, Alpay et al. 2005).
In Western medicine, recent studies have shown that steroids are probably
effective and that the drug acyclovir combined with
prednisone is possibly effective in improving facial function. This is now the
protocol of choice for Western doctors.
Other treatments are usually aimed at protecting the eye from drying at
nighttime. Some physicians may prescribe a corticosteroid drug to
help reduce inflammation and an analgesic to relieve pain.
The prognosis for Bell's palsy is generally very good. With or without
treatment, most patients begin to get significantly better
within 2 weeks, and about 80 percent recover completely within 3 months. For
some, however, the symptoms may last longer. In a few
cases, the symptoms may never completely disappear.
Acupuncture Therapy
I treat Bell's Palsy in my practice all the time, as acupuncture gets incredible
results. My choice of protocol is electro-stimulation acupuncture. This
effectively stimulates the facial nerves on a deeper level than TENS,
electro-pads or anti-viral medications alone. I have found that approximately
12-14 treatments are needed to return the face back to its normal look and feel.
This form of acupuncture stops pain, relaxes the facial paralysis, brings the
feeling back through the nerve endings, stops the drooling and tearing and helps
the eye close again. This protocol essentially returns the face back to normal
in one-third the time of any other treatment I have seen for this disorder.
Bell's Palsy (Zhong Feng) is considered a Wind Attack or External Wind Stroke
attack. The main pattern differentiation being a Wind invasion due to emptiness
of the Channels (Maclean and Lyttleton 1998). In Chinese Medicine, Wind is said
to be the carrier of 1,000 diseases. Wind is thought to take advantage of the
deficiency (weakness) a patient is experiencing and enters the body attacking
the sinews and vessels in the area of the face. This results in vital energy
(Qi) and the blood to stagnate causing the inability of the facial muscles to
relax and therefore contract (Wolfe 2003). The principle of treatment is to
expel Wind and promote the movement of Qi and blood by scattering the
stagnation.
More times than not, the patient that walks into my office is often, under great
stress! They are either dealing with work related stress, having difficulties in
their home or family life and are often the type A personality.
As I work in the area of fertility, it is the occasional pregnant patient that
will present with this disorder, as well.
Patients who come in for treatment of Bell's Palsy will often tell me they sleep
with a fan on them (wind) or near an open window. I seem to get a flux of Bell's
patients in the office in the Spring and Fall more than any other seasons.
Bell's Palsy is the most common disease of the facial nerve. It is presumably
due to an inflammatory reaction in or around the facial nerve near the
stylomastoid foramen. According to Liu (1995), when acupuncture was initiated
within three days postonset
in 684 cases of facial nerve paralysis, 100 percent of the patients were cured
or there was a marked improvement (5). Other
studies (Gao, Chen, 1991) revealed that 80% of cases that were treated at more
than 2 months post-onset, and 83 percent of severe
cases, were cured or had excellent effect (6). Treatment, as with this patient,
may include numerous diagnostic procedures, different
classes of medications, lifestyle alterations, and still, continued suffering.
Acupuncture may often lead to significant clinical
improvement (7).
Acupuncture points used in this protocol include Stomach 2,3,4,5,6,7 Bitong,
Large Intestine 19, 20, Small intestine 18, Gall Bladder 14, 20, YuYao, San Jiao
17, Du 26, Du 20, Urinary Bladder 2, JiaChengJiang, Yintang, TaiYang, Stomach
36, Gall Bladder 34, Liver 3, Large Intestine 4, Lung 7, San Jiao 5 and Spleen
6.
Herbal Therapy
For patients who are not pregnant, an herbal formula is recommended based on
their pattern and signs and symptoms. The most important herbs for this disorder
should include herbs to treat wind attack and anti-viral herbs such as Qin Jiao,
Fang Feng, Xi Xin, Bai Shao, Di Long, Fu Ling, Gan Cao, Chuan Xiong, Pu Gong
Ying, Dang Gui.
Variations on this formula are important to change as the patient's situation
change.
In conclusion, Bell's palsy is a physical and emotionally debilitating condition
in which conventional medicine has limited understanding and efficacy. The
exposure to external sources (stress, environment) cause the immune system to
produce an inflammatory response. This inflammation can then obstruct the normal
function of the nerves and vessels resulting in paralysis. Chinese medicine has
treated conditions such as Bell's palsy for centuries. Chinese medicine and
acupuncture on a regular basis can significantly improve results and help to
resolve this condition.
Andrew Pacholyk, MS, L.Ac.
Therapies for healing
mind, body and spirit
(peacefulmind.com)
References
1. O'Connor J, Bensky D. Acupuncture a comprehensive text. Seattle: Eastland
Press 1981; 367-372.
2. Ibid, 609-610.
3. Stux G, Pomeranz B. Acupuncture textbook and atlas. Berlin: Springer-Verlag
1987; 296.
4. Evans RA, Hames ML, Baguley DM, Moffat DA. Reliability of the House and
Brackmann grading system for facial palsy. J Laryngol Otol
Nov 1989; 103(11): 1045.
5. Liu YT. A new classification system and combined treatment method for
idiopathic facial nerve paralysis: report of 718 cases. Am JAcup
1995; 23(3),205-210.
6. Gao HB, Chen D. Clinic al observation on 60 cases of peripheral facial
paralysis treated with acupointure penetration needling. Int
J Clin Acup 1991; 2(1),25-28.
7. NIH Consensus Development Conference on Acupuncture, National Institutes of
Health, Bethesda MD, Nov 1997; 93-109.
8. Gok, U., H. C. Alpay, et al. (2005). "Comparisons of steroid, acyclovir,
lipoprostoglandin E1 and steroid + acyclovir treatments in facial paralysis: A
rat study." International Journal of Pediatric Otorhinolaryngology 69(9):
1199-1204.
9. Grogan, P. and G. Gronseth (2004). "Practice parameter: Steroids, acyclovir,
and surgery for Bell's palsy (an evidence-based review): Report of the Quality
Standards Subcommittee of the American Academy of Neurology." Neurology 56(7):
830-836.
10. Hato, N., S. Matsumoto, et al. (2003). "Efficacy of early treatment of
Bell's palsy with oral acyclovir and prednisolone." Otology & Neurotology:
Official Publication Of The American Otological Society, American Neurotology
Society [And] European Academy Of Otology And Neurotology 24(6): 948-951.
11. He, L., D. Zhou, et al. (2004). "Acupuncture for Bell's palsy." Cochrane
Database Syst Rev(1): CD002914.
12. He, S., H. Zhang, et al. (1995). "Review on acupuncture treatment of
peripheral facial paralysis during the past decade." Journal of Traditional
Chinese Medicine 15(1): 63-67.
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