Facial Paralysis

Question 1

Which nerves system does Bell Palsy affect

Answer 1

Peripheral

Question 2

Which nerve get damaged if Bells palsy is involed

Answer 2

cranial nerve 7

Question 3

what are the causes of bell palsy?

Answer 3

there are no clear cause but a couple causes

1. edema
2. compression of facial nerve
3. Quick onset: pain might radiate from mastoid
4. might be an immuno-response
5. similiar to trigeminal neuralgia
6. Unilateral, stiff face

Question 4

what kind of complications happen with patients with bell palsy

Answer 4

facial spasm
cornea ulcers
but majority will recover within 3 months

Question 5

How would the disease side manifest?

Answer 5

1. Inability to wrinkled forehead
2. Upwards rolling of eyeball
3. Inability to close eyes - muscle paralysis
4. Inability to puff out cheeks (Qi leaking)
5. Lack of smile (unilateral frown)

Question 6

Which meridians would be involved?

Answer 6

Shaoyang and Yangming

Question 7

What complains would be presented in Shaoyang meridians

Answer 7

pain in the ear, behind the ear, mastoid, hyper sensitive hearing

Question 8

what complains would be present in a yangming meridian?

Answer 8

loss of taste, affects anterior 2/3 of tongue

Question 9

POT of Bells Palsy

Answer 9

Dispel wind, circulate collaterals
If combine with cold - dispel cold, warm cold
Focus on yangming and shaoyang
Provide distal and local points
Early stages - Gentle Shallow stimulate: let the patient know, the disease is still in-progress in the first week of presentation
1st week - 10 days: stronger stimulation, and more needles

Question 10

education

Answer 10

avoid EPF invasion
encourage local mx, heat compression, several times a day
prevent eat infection, wear sunglasses will improve recovery rate
*note - after using corticosteroids, patient will react poorly to acupuncture

Question 11

Which local points would you use?

Answer 11

SJ17 GB34, ST2, 4, 6, 7

Question 12

List the patterns of Facial Paralysis

Answer 12

1. Phlegm/Blood Stasis
2. Wind cold
3. Wind Heat

Question 13

Sudden onset, wry mouth and eyes, incomplete closure of eye on affected side
Aversion to wind cold, mild fever, facial muscle tightness which is alleviated by warmth
Tongue: Thin and white
Pulse: Tight and superficial or tight and moderate

Answer 13

Wind Cold Syndrome

Question 14

Sudden onset, wry mouth and eyes, incomplete closure of eye on affected side. Bitter taste in mouth dry or sore throat, burning pain the mastoid region or eat, facial muscle weakness or flaccid, fever, mild chill
Tongue: Red tip, thin yellow coating
pulse: rapid, wiry or superficial and rapid

Answer 14

Wind heat syndrome

Question 15

Prolonged wry mouth and eye, stiffness and numbness of the face, facial contractures, dull and dark face, heaviness in the head (indication of dampness)

tongue: dark or purple, with white and sticky coating
pulse: slippery, wiry and choppy

Answer 15

phlegm/blood stasis

Question 16

would you see hemiplegia in bells palsy or central paralysis

Answer 16

central paralysis

Question 17

what is the cause of central paralysis

Answer 17

injury of cerebral hemisphere of brain stem caused by cerebrovascular diseases, intracranial tumors, head injuries, brain infections