Neural and Mental Diseases

Acupuncture Pair Points for peripheral facial paralysis
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Disease and Condition Overview
Peripheral facial paralysis is characterized by the unilateral paralysis of facial muscle due to facial nerve injury. In Chinese  Medicine, exhaustion, normal, healthy qi deficiency, emptiness of channels and luo-channels, as a result, lowers the defensive qi. Therefore, wind cold or wind heat takes advantage and attack the channels, causing the stagnation qi and blood, dysfunction of channels, inability to control muscles, resulting in paralysis of mouth and eyes. Traditionally, it is classified as "deviation of eye and mouth".
Clinically, symptoms are resembled that of Bell's Palsy.

Pair-point Treatment Combinations

(1) Dicang (ST4), Jiache (ST6) (Fig 47)
Dicang (ST4): on the face, eyes looking  forward, the point is directly below the pupil, 0.4 cun lateral to the corner of the mouth.
Jiache (ST6) : on the cheek, one finger breadth anterior and superior to the manidbular angle, at the prominence of the masseter muscle.
Dicang (ST4) and Jiaehe (ST6) are both points on the face of foot-yangming channels, regulating local qi and blood. This pair point combination, work in synergy, stimulate and regulate the qi in the local channels on the face and around the mouth. Appropriate for peripheral facial paralysis with face and mouth deviation.

Needling techniques:
Dicang (ST4) and Jiache (ST6) both points diagonally opposed, needle subcutaneously. Usually, transverse  insertion 1-2 cun.
Or moxa using moxa stick for 15 minutes.
Or moxa on both Dicang (ST4) and Jiache (ST6) points or separately, 3-5 moxa sections, or 5-10 minutes.

(2) Lieque (LU7), Wangu (GBI2) (Fig 48)
Lieque (LU7) : on the radial aspect of the forearm, above the styloid process of the radius, 1.5 cun proximal to the transverse crease of the wrist, between the tendons of brachioradialis and abductor pollicis longus.
Wangu (GB12): on the head, in the depression posterior and inferior to the mastoid process.
Lieque (LU7) is hand-taiyin channel  Luo-connecting  point, connecting the qi and blood of the channels in the neck and nape. Wangu (GB 12) is the foot-shaoyang channel, the foot-taiyang channel confluence point. This pair-point combination, one superior and one inferior, disperse the qi and blood in channels located on the face and neck. Appropriate for peripheral facial paralysis accompanied by pain behind the years and discomfort in the neck and nape area.

Needling techniques:
Lieque (LU7) upwards oblique insertion 0.5-1 cun, Use dao-qi or the "guiding qi" method, manipulate for 1-2 minutes.
Wangu (GB12) perpendicular insertion or slightly forward oblique insertion 1-1.5 cun, after needling, apply moxa stick for 20 minutes.

(3) Shuigou / Renzhong (DU26), Fengfu (DU16) (Fig 49)
Shuigou (DU26) : on the face, at the unction of the upper third and middle third of the philtrum.
Fengfu (DU16): on the neck, 1.0 cun superior to the midpoint of the posterior hairline, directly below the external occipital protuberance, in the depression between the trapezius muscle of both sides.
Shuigou / Renzhong (DU26) dispelles wind and clears heat, stablizes shen and opens the luo- connecting channels ; Fengfu ( DU 16 ) disperses wind, tranquilizes and calms the mind. This pair point combination, one anterior, one posterior, administering from both sides, dispersing wind and pathogenic factors, tranquilizing and calming the mind. Appropriate for acute peripheral facial paralysis with apparent wind symptoms.

Needling techniques:
Shuigou / Renzhong ( DU26 ) upwards oblique insertion 0.5 cun.
Fengfu (DU16) perpendicular insertion 0.5-1 cun.

(4) Xiaguan (ST7). Hegu (LI4) (Fig 50)
Xiaguan ( ST7 ) : on the face, anterior to the ear, in the depression between the zygomatic arch and mandibular notch.
Hegu (LI4) : on the dorsum of the hand. midway between the junction of the first and second metacarpal bones.
Xiaguan (ST7) is foot-yangming and shaoyang confluence point on the face, reduced yangming and shaoyang qi, dispel wind opens orifices ;Hegu (LI4) hand-yangming channel yuan-source point, dispels wind, releases the exterior, opens channels and invigorates luo-connecting channels. This pair point combination, one superior, one inferior, both on the same channel, their efficacy resonate to invigorate qi and blood of the yangming and shaoyang channels, dispel wind, open the luo-connecting channels. Appropriate for all types of peripheral facial paralysis.

Needling techniques:
Xiaguan ( ST7 ) perpendicular insertion 1 cun.
Hegu ( LI4 ) perpendicular insertion 1 cun.

(5) Yifeng (SJ17), Tinghui (GB2) (Fig 51)
Yifeng (SJ17) : posterior to the ear lobe, in the depression between the mastoid process and manipular angle.
Tinghui ( GB2) : on the face, anterior to the intertragic notch. When the mouth is open, the point is located in a depression posterior to the condyloid process of the mandible.
Yifeng (SJ17) regulates qi in sanjiao (upper, middle and lower jiao ), dispelles wind and opens the luo-connecting channels; Tinghui (GB2) regulates liver and gallbladder qi, dispelles wind and clears heat. This pair point combination, both on the same channel, their efficacy resonate to invigorate qi and blood to relieve shaoyang, open luo-connecting, govern the opening and closing of channels. Appropriate for peripheral facial paralysis accompanied by pain around the ear, sensitive hearings.

Needling techniques:
Yifeng (SJ17) from lateral, posterior to medial and anterior, oblique insertion 1 cun.
Tinghui (GB2) perpendicular insertion 1 cun.

Dicang (ST4) and Jiache (ST6), these pair points are usually used as main local points. Clinically, they are very important in treatment, especially the use of moxibustion.
Lieque (LU7) and Wangu (GB12), this pair point is proximal and distal point combination. In clinical treatment, it is recommended that one should first needle Lieque (LU7), then needle Wangu (GB12). For patients with neck and nape pain, or pain behind the ear, this pair point is essential in treating these symptoms.

At the early stage, select transverse insertion Dicang (ST4), Jiache (ST6) ; However, after the initial onset of the paralysis, apply moxa instead of needling. Using moxa after  using transverse insertion at the beginning of the disease will shorten the treatment cycle and quicken the recovery.
Lieque (LU7), Wangu (GB12) is a great example of the proximal and distal point
combination. Lieque (LU7) is often combined with dao-qi or the "guiding qi" method; moxibustion or warm needle is used on Wangu (GB12).
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