Facial Paralysis

Question 1

Which nerve is affected?

Answer 1

7th cranial nerve (innervated 2/3 tongue= motor function/taste/speech)

Question 2

Symptoms

Answer 2

quick onset, worse in the morning (stiffness, unilateral)
unable to wrinkle forehead
upward rolling eyes
unable to close eyes
unable to puff out cheeks
asymmetrical smile
loss of taste
lacrimation, drooling

Question 3

prognosis

Answer 3

good, most recover in 3 months tx

Question 4

etiology

Answer 4

yangming and shaoyang meridians wei qi is weak allowing EPF to invade

Question 5

Patterns:

Answer 5

1) W-C
2) W-H
3) PH/blood stg

Question 6

sudden onset, wry mouth and eye, incomplete closure of eye on affected side, bitter taste in the mouth, dry/sore throat, burning pain in mastoid/ear, facial muscle weakness, fever, mild chills

Answer 6

W-H

Question 7

W-H T/P:

Answer 7

T-red tip, thin yellow coat

P- superficial, rapid, wiry

Question 8

W-H points

Answer 8

SJ-5, LI-11, ST-44

Question 9

prolonged wry mouth and eye, stiffness and numbness of face, facial contractions, dull/dark face, heavy head

Answer 9

PH/blood stg

Question 10

PH/blood stg T/P:

Answer 10

T-dark, purple, white sticky coat

P- slippery, wiry, choppy

Question 11

PH/blood stg points

Answer 11

ST-40, SJ-10 (moxa)

Question 12

sudden onset, wry mouth and eye, incomplete closure of eye on affected side, aversion to wind-cold, mild fever, facial muscle tightness, alleviated by warmth

Answer 12

W-C

Question 13

W-C T/P:

Answer 13

T- thin white coat

P- superficial, tight, moderate

Question 14

W-C points

Answer 14

GB-20, LI-4, SJ-17 (moxa)

Question 15

differentiate: bells palsy VS central paralysis

Answer 15

bells palsy VS Central
-cranial 7 nerve -injury of cerebral
compressed at hemisphere or
temporal bone brainstem by
by edema (unknown tumors, head injuries
cause/virus)
-inability to wrinkle/frown -normal
-inability to close eyelid -normal
-diminished corneal relfex -normal
-normal -hemiplagia
-normal -other cranial nerve paralysis

Question 16

complications:

Answer 16

facial muscle contraction

Question 17

differentiate yangming VS shaoyang

Answer 17

yangming= loss of taste
shaoyang= painful.tender mastoid/ear, sensitive hearing, hearing disorders

Question 18

Chronic case pattern/sx:

Answer 18

LIV blood xu fails to nourish tendons
throbbing tight muscle, mouth deviated to disease side (opposite to normal)
LIV-3, SP-6, LIV-8

Question 19

POT:

Answer 19

disperse wind, circ. collaterals

Question 20

early stage VS late stage TX:

Answer 20

early (1st week)= shallow, gentle stim., less local points
*notify patient that disease is still progressing and may not get
better after the first TX
late (7-10 days after)= more local points, strong stim., deep

Question 21

ALT remedies:

Answer 21

1) moxa (cold)
2) bleed (heat)
3) electro= low freq (2-4 HZ) St-4/6/7
4) flash cupping (pull muscle up/back)
5) auricular (cheek, mouth, eyes, LIV)
6) warming needle SJ-17 (chronic case)

Question 22

extra point

Answer 22

qian zheng (1 cun anterior to SJ-17)

Question 23

EDU:

Answer 23

1) avoid EPF
2) heat compress/self-massage several times a day (upward motion)
3) prevent eye infection (drops, wear sunglasses)

Question 24

**

Answer 24

cortisone/steroid patients dont respond as well to acupuncture

Question 25

2 kinds:

Answer 25

1) peripheral (bells palsy)

2) central (stroke/brain damage)