Bell’s Palsy

I am a 31 years old female social worker living in Tarzan, California. In mid-July 2011, when I woke up I had a strange feeling in my face. When I looked at the mirror, I found my face was distorted with mouth angle and tongue deviated to the right side which frightened me very much. I cannot close my left eye completely and saliva drooped from the left mouth angle. At that time I was pregnant and one week to term. So I didn’t go to see any doctor for treatment. Doing some massage on the face could not improve the condition. One week after I delivered my twin girls, under the advice of my clinical pharmacist sister, I rushed to Acuhope Center for acupuncture treatment. Paralysis of left facial nerve, all three branches, was diagnosed and electroacupuncture was applied. Right after the first treatment I felt the stiffness of my face was lesser and can move my lips to the center with force which I cannot do before. Two treatments a week was planned to work on me. After the third treatment I can make wrinkle on my forehead. After the sixth treatment my lips were back to the center and I can easily griming. Now, a sunshine smiling can be made on my face. I was complete recovery in one moth with 8 treatments. The result of treatment surprised my family and friends. Thank you for Dr. Kwan. Thank you for the amazing Acupuncture.    

 Natalie Z, Canoga Park, California, 2012

                                                                                                

I’m 55 years old working as a Client Manager in a company located in Canoga Park, California.  In the late April, 2006 I contracted a common cold and found to have a cold sore on my lip. On the last weekend in April, I flew to Oregon to visit my elderly Aunt.  I returned to Southern California late Sunday evening. On Monday, my cold was mostly gone.

When I woke on Tuesday, the whole left side of my face was numb.  It was not only numb, it was motionless.  My eye was completely dry and would not blink.  My vision was a bit blurry and my ear hurt. Tuesday afternoon I saw my physician who diagnosed my condition as “Bell’s Palsy”.  She prescribed prednisone and an antiviral medication.  Prognosis for my condition?  3 to 6 months of paralysis with a slow recovery.

I was so worry, and fortunately a friend referred me to Dr. Kwan at the Acuhope Center.  She treated me with acupuncture – both for the facial paralysis and for the immune system issues that were causal in its onset.  After the second treatment, I began to have spasms in my face and a slight improvement in my ability to blink. Dr. Kwan saw me three times a week for a total of 10 treatments. By the 8th treatment, my condition had improved to the point that colleagues expressed amazement. There was very little indication that anything had ever been wrong with me.  Dr. Kwan used needles, electricity and heat and facial massage to treat me.  She also gave me ‘homework’ the application (twice daily) of heat followed by massage of the afflicted area. The treatments themselves were something I looked forward to.  The insertion of the needles was painless, the heat felt wonderful, and the atmosphere was peaceful and relaxing. 

I am so grateful for Dr. Kwan.  Without her, my face would likely still be numb, my taste buds dead, and my eye dry.  THANK YOU!!!

Myrna (Beth) Thompson, California, 2007 

Bell’s Palsy, facial nerve paralysis, is a disorder of the 7th cranial nerve (facial nerve) that controls movement of the muscles in the face. Damage to the facial nerve causes weakness or inability of these muscles. Bell’s palsy is thought to be due to inflammation and swelling of this nerve in the area where it travels through the bones of the skull. Bell’s palsy affects about 30,000 to 40,000 people a year in the United States. Bell’s palsy can occur at any age, with a peak incidence observed in the 40s, and its cause is often not clear, most probably due to a viral infection. Persons who tend to be most at risk are pregnant women, and persons afflicted with the flu virus, cold, respiratory illness, or diabetes. Some patients have reported having severe ear, nose, mouth or gum infections and/ or headaches prior to developing Bell’s palsy.

Symptoms are almost on one side of the face only. They may range from mild to severe. One or all of the followings can be occurred:

  • Face pulled to the healthy side with stiffness, numbness or tingling
  • Difficulty closing the eye on the affected side with tearing
  • Drooling and food falls out of the mouth
  • Drooping of the face, eyelid or corner of the mouth
  • Problems smiling, speech, grimacing, or making facial expression
  • Loss of ability of taste
  • Twitching or weakness of the facial muscles
  • Dry eye, dry mouth
  • Headache
  • Depress

If the symptoms are mild, it might not need treatment. Some will remain the same without improvement for years. Most of the people would not wait for weeks or months to see a self-healing. The appearance of an ugly face and the inability of facial muscle would urge the patient to seek for immediate treatment. Medication, such as corticosteroids, antivirals, anti-inflammatory, and physical therapy are used as a conventional therapy for Bell’s palsy. Acupuncture had been shown its fast and good result on Bell’s palsy.

The prognosis for Bell’s palsy ranges from complete recovery within a few weeks (85% of patients) to chronic symptoms of facial paralysis (15% of patients). In addition, it is necessary to rule out other causative factors for facial paralysis including those that affect the central nervous system such as cerebrovascular accidents (stroke) and intracranial tumors.

Acupuncture for Bell’s palsy

Acupuncture is often very successful in relieving the facial paralysis especially when treatment is begun within the first two weeks of occurrence. Acupuncture treatment uses natural pressure points on the body to increase local microcirculation, neurotransmitters, and neurohormones to relieve pain, swelling and inflammation promoting the healing process. The acupuncturist inserts small, thin disposable needles into the skin in a number of points throughout the face and body to gain the effects. There is no harmful side effect to this treatment.

What we do

Standard steps we approach to patient with Bell’s palsy:

1. Record detail history of illness to rule out other disease.

2. Review test data and imaging result (X-ray, CT scan, MRI).

3. Perform physical examination and movement test.

4. Propose a treatment plan.

5. Common acupuncture points used include: Ear sympathetic, Adrenal, face; local points related to the involved branch of facial nerve; and distal analgesic and energy points.

6. Add Electric stimulation.

Demography of Bell’s palsy patient and treatment results of our clinic

Study data draw from 2003 to 2007. Age: 45 to 80, average 63. Gender: F: M=3:1

Diagnosis

% of total pain patients % of Improvement % of marked improvement

Average treatment

Bell’s palsy

0.7

100 100

6

Literatures review

Zhou ZL, et al. Correlation between facial nerve functional evaluation and efficacy evaluation of acupuncture treatment for Bell’s palsy. Zhong Xi Y Jie Xue Bao. i2012 Sep;10(9):997-1002

The authors gave acupuncture treatment to 68 patients with Bell’s palsy according to the state of the disease without artificially setting the treatment period. House-Brackmann scale, a commonly used evaluation scale for facial paralysis motor function, was employed and set standards for eye fissure and lips. According to the improved scale, the authors assessed and graded the degree of facial paralysis both before and after treatment. The grade was divided into five levels: mild, moderate, moderately severe, severe dysfunction and complete paralysis. The observation was focused on the efficacy and the efficacy was evaluated throughout the entire treatment process.

53 cases with Bell’s palsy were cured and the overall rate of efficacy was 97%. Efficacy was correlated with the damage level of the disease. The course of treatment also extended with the severity of facial nerve dysfunction. Differences exist in patients with Bell’s palsy in terms of severity of facial nerve dysfunction. Efficacy is reduced in correlation with an increase in facial nerve dysfunction, and the period of treatment varies in need of different levels of facial nerve dysfunction. It is highly necessary to assess and grade patients before observation and treatment in clinical study, and choose corresponding treatment according to severity of damage of the disease.

Liu LA, et al. Comparison on efficacy and the safety evaluation on peripheral facial paralysis treated with electroacupuncture of different waveforms. Zhongguo Zhen Jiu 2012 Jul;32(7):587-90

To use electroacupuncture of different waveforms to treat Bell’s palsy and assess the clinical efficacies of 3 kinds of EA waveforms: continuous wave, disperse-dense wave and intermittent wave. 129 cases of Bell’s palsy were randomly divided into a continuous wave group (45 cases), a disperse-dense wave group (40 cases) and an intermittent wave group (44 cases). The acupoints were ST 4, ST 6, Taiyang , ST 7, LI 4, etc. The cured rates were 68.9% in the continuous wave group, 60.0% in the disperse-dense wave group, and 65.9% in the intermittent wave group.  The results of the rank sum test showed that the efficacy comparison among the groups did not present the statistically significant difference. Conclusion: Electroacupuncture achieves the significant clinical efficacy on Bell’s palsy and there are no any significant differences in the efficacy among the different waveforms. It is suggested that the clinical efficacy of electroacupuncture on the disease has nothing significant correlation with the waveforms.

Wang Y. Clinical observation on treatment of acupuncture for different stages of Bell’s palsy. Zhongguo Zhen Jiu. 2010 Jan;30(1):23-6.

Forty cases of Bell’s palsy patients were divided into three groups according to their onset time: an active stage group, a resting stage group and a recovery stage group. The scores were evaluated with Sunnybrook Facial Nerve Evaluation System and Facial Disability Index Questionnaire (FDI). All three groups were treated with acupuncture on the same acupoints. The therapeutic effect was evaluated again by scoring after the clinical recovery or treatment of 20 times. Results shown Acupuncture was effective for the Bell’s palsy in all three groups, yet it was obviously superior in the active stage than the other two groups. There was no significant difference between the resting stage group and the recovery stage group. Conclusion: Acupuncture has a good therapeutic effect for treatment of Bell’s palsy, and the therapeutic effect is most obvious with intervention of treatment in the active stage.