FACIAL PARALYSIS

GENERAL

Clinical Manifestations
Treatment Principle
Herb Formulas
Points	Hypoglossal Muscle: DU-15, LI-4, REN-23 Mandibular Nerve: DU-20, GB-20, LI-4, SJ-17, SJ-21, ST-4, ST-6, ST-7 Sublingual Nerve: GB-5, GB-20, HT-5, LI-17, PC-7, REN-23, UB-10

TAI YANG SHANG HAN

Clinical Manifestations	Facial paralysis Chills and fever Anhidrosis Stiff and rigid neck, shoulders and upper back Intolerance of Wind Dislike of Cold Inflammation Diarrhea Muscle spasms Mucosal swelling Nasal congestion Sensitivity to dust Headache Wind-Cold Bi (few joints affected, inflammation intense but short lived, changes over days or weeks) T: Normal C: Thin and white P: Floating and tight
Treatment Principle	Release Wind-Cold in the exterior and muscle layer Generate Fluids Relieve muscle-ache of the neck
Herb Formulas	Ge Gen Tang Fu Zi Tang
Points

WIND-COLD INVASION DUE TO WEI QI DEFICIENCY

Clinical Manifestations	Hemiplegia Asymmetry of the face Paralysis of the face Slow and slurred speech Aphasia Fever and chills Semi-consciousness Loss of consciousness Convulsions Neck rigidity Limited movement of the joints Loss of consciousness Muscle spasms Low back pain Numbness of the muscles and skin Hemiplegia Urticaria T: ; Pale C: Thin and white P: Floating and Empty or Tense or Wiry and tense
Treatment Principle	Warm the channels Disperse Wind Releases Yang Supports the Qi
Herb Formulas	Xiao Xu Ming Tang
Points

TAI YANG - SHAO YANG

Clinical Manifestations	Facial paralysis Sensation of extreme Cold Severe chills Chills are not relieved by clothing or covers Slight fever Anhidrosis Exhaustion Almost constant desire to sleep Pale face Cold extremities Cold feet Severe aversion to Cold Headache Shortness of breath Fatigue Joint pain Edema Cough Pain penetrating to the back Toothache Sore throat Raspy voice Edema due to Wei Qi Stagnation Weak extremities Chronic wheezing Severe pain and obstructed feeling over the throat T: Pale and swollen C: White and slippery P: Deep and weak
Treatment Principle	Disperse Wind-Cold Replenish Yang
Herb Formulas	Ma Huang Fu Zi Xi Xin Tang
Points

TAI YANG - SHAO YIN

Clinical Manifestations	Facial paralysis Sensation of extreme Cold Severe chills Chills are not relieved by clothing or covers Slight fever Anhidrosis Exhaustion Almost constant desire to sleep Pale face Cold extremities Cold feet Severe aversion to Cold Headache Shortness of breath Fatigue Joint pain Edema Cough Pain penetrating to the back Toothache Sore throat Raspy voice Edema due to Wei Qi Stagnation Weak extremities Chronic wheezing Severe pain and obstructed feeling over the throat T: Pale and swollen C: White and slippery P: Deep and weak
Treatment Principle	Disperse Wind-Cold Replenish Yang
Herb Formulas	Ma Huang Fu Zi Xi Xin Tang
Points

WIND OR WIND-HEAT INVASION DUE TO WEI QI DEFICIENCY

Clinical Manifestations	Hemiplegia Asymmetry of the face Paralysis of the face Slow and slurred speech Aphasia Fever and chills Semi-consciousness Loss of consciousness Convulsions Neck rigidity Limited movement of the joints Loss of consciousness Muscle spasms Low back pain Numbness of the muscles and skin Urticaria T: ; Pale C: Thin and white P: Floating and Empty or Tense or Wiry and tense
Treatment Principle	Warm the channels Disperse Wind Releases Yang Supports the Qi
Herb Formulas	Xiao Xu Ming Tang
Points	General points

WIND-HEAT BI

Clinical Manifestations	Whole body numbness Deviation of mouth and eyes Numbness of skin Dysphagia due to stiffness of the tongue Facial paralysis Hemiplegia Rigidity of the extremities Spasms of the extremities Aversion to Cold Fever Chills Aching joints Tingling of the skin Paralysis of the extremities Numbness and lack of sensation in the hands and feet Common cold (with above symptoms) Inability to walk Wandering joints pain T: Pink or Red C: White or Thin yellow P: Superficial or Superficial and wiry or superficial and tight or Wiry and thin
Treatment Principle	Dispel Wind Clear Heat Circulate Qi Dredge the channels Nourish and invigorate the Blood Harmonize the Ying and Wei
Herb Formulas	Da Qin Jiao Tang
Points

WIND-DAMPNESS

Clinical Manifestations	Wandering joint pain, especially the wrists, elbows, knees and ankles Chills and fever Atrophy above and below the knees Limited movement Paralysis of knees One or both knees swollen, enlarged and painful Stiffness of knees Legs so weak and sore after dysentery that it is difficult to walk Generalized pain and numbness in the legs Hemiplegia Dizziness Neuralgia Paralysis, stiffness, swelling and pain of feet Atrophy of the leg muscles Chest oppression Lumbago Tinnitus T: Pink or Pale and swollen or Red C: Thin white or Greasy white P: Superficial and tense or tight or Deep and thin or Deep and weak or Deep, slow and weak
Treatment Principle	Dispel Wind Activate Qi and Blood TonifY Qi and Blood Eliminate Cold-Dampness TonifY Yang Strengthen the muscles, tendons and bones
Herb Formulas	Da Fang Feng Tang
Points	General points

WIND-DAMPNESS WITH QI AND BLOOD DEFICIENCY

Clinical Manifestations	Joint pain Numbness Bones and joints sore and painful Worse with movement Face is dull yellow Spasms or contractures of muscles and sinews Palpitations Asthenia Shortness of breath Spontaneous sweating Weight loss Poor appetite Diarrhea T: Pale C: None or White P: Soggy and Weak or Thin and Faint
Treatment Principle	Activate the functions of the Liver and Kidneys Strengthen Qi Nourish the Blood Expel Wind and Dampness Stop numbness and pain
Herb Formulas	Ba Xian Tang Jia Wei Ba Xian Tang
Points

WIND-COLD-DAMP

Clinical Manifestations	Facial paralysis Sciatica pain The pain is intense and moves around Swollen painful joints (especially lower limbs) Joints are warm to the touch (may be burning and swollen) The pain is worse at night Reduced range of motion Joint degeneration or deformity in the lumbar region Chills Anhidrosis Weight loss Shortness of breath Muscular atrophy Difficulty walking and moving Thirst Hemiplegia Rigidity of the limbs Headache Dizziness Vertigo Nausea Vomiting Edema Emaciation Swollen feet Numbness of the extremities Paralysis Fatigue T: Normal C: White and greasy or Thin, yellow and greasy P: Wiry and slippery or Slippery and rapid
Treatment Principle	Unblock Yang Qi Promote the movement of Qi Dispel Wind Eliminate Dampness Clear Heat Unblock the channels and collaterals Stop pain
Herb Formulas	Juan Bi Tang
Points

WEI QI DEFICIENCY

Clinical Manifestations	Facial paralysis Aversion to Wind and Cold Spontaneous sweat Recurrent colds Shiny, pale complexion Increased susceptibility to external invasion T: Pale or pink C: White P: Floating, Deficient and soft
Treatment Principle	Tonify Qi Stabilize the exterior Stop sweat
Herb Formulas	Yu Ping Feng San
Points

PHLEGM OBSTRUCTS THE HEART ORIFICE: YANG OBSTRUCTION

Clinical Manifestations	Sudden collapse with loss of consciousness Lockjaw (trismus) Eyes open Both fists clenched Retention of urine Constipation Stiffness and spasm of limbs Red face Body feels hot Coarse breathing Bad breath Restlessness Involuntary movements Usual sequelae of C.V.A. such as: Hemiplegia Aphasia Facial paralysis T: Pink C: Yellow and greasy P: Slippery, wiry and rapid
Treatment Principle	Clear Phlegm Open the Orifices
Herb Formulas	(Ju Fang) Zhi Bao Dan Ling (Yang) Jiao Gou Teng Tang An Gong Niu Huang Wan San Sheng San
Points	Bleed the Jing-Well points of the Six Hand channels, needle DU-20, DU-26, KI-1, LIV-3, ST-40

PHLEGM OBSTRUCTS THE HEART ORIFICE: YIN OBSTRUCTION

Clinical Manifestations	Sudden collapse with loss of consciousness Lockjaw (trismus) Eyes open Both fists clenched Retention of urine Constipation Stiffness and spasm of limbs Pale face with bluish lips Limbs cold, pale and still Lying peacefully Usual sequelae of C.V.A. such as: Hemiplegia Aphasia Facial paralysis T: Pink C: White and greasy P: Deep, slippery and even
Treatment Principle	Open the Heart Orifices with Pungent Warming Herbs Eliminate Phlegm Subdue Wind
Herb Formulas	Su He Xiang Wan Di Tan Tang San Sheng San
Points	Bleed the Jing-Well points of the Six Hand channels, needle DU-20, DU-26, KI-1, LIV-3, PC-5, ST-40, UB-20

LIVER WIND STIRRING INTERNALLY: LIVER YANG (FIRE) RISING GENERATES WIND

Clinical Manifestations	Dizziness and vertigo to the point of falling over Headache with a drawing sensation Numbness and tremor of limbs Twitching and involuntary writhing of hands and feet Dysphasia Unsteady gait Paraplegia With Wind-Stroke: Sudden loss of consciousness Tongue stiffness with aphasia Facial paralysis Hemiplegia Maybe coma Sometimes death T: Red P: Thready and wiry
Treatment Principle	Nourish Yin Pacify the Liver Subdue Wind
Herb Formulas	Zhen Gan Xi Feng Tang Tian Ma Gou Teng Yin Qu Feng Zhi Bao Dan
Points	Bleed the Jing-Well points of Six Hand Channels, needle DU-20, DU-26, GB-20, GB-34, KI-1, KI-3, LIV-2, LIV-3, PC-8, UB-18, UB-23

LIVER AND KIDNEY YIN DEFICIENCY

Clinical Manifestations	Facial complexion pale and sallow Both cheeks slightly red Dizziness Dry eyes Blurred vision Spots before the eyes Numbness of limbs Flaccid paralysis (Wei syndrome) Weakness Tinnitus Deafness Forgetfulness Low back and knees sore and painful Throat dry and painful Five sole Heat Low-grade fever Night sweats Irritability Insomnia Stools difficult to pass Constipation Men: Spermatorrhea Women: Irregular menses or Scanty menses or Amenorrhea Vaginal discharge T: Red C: None P: Thready and rapid
Treatment Principle	Nourish and Reinforce the Liver and Kidneys
Herb Formulas	Da Bu Yin Wan Liu Wei Di Huang Wan Yi Sui Tang Zi Shui Qing Gan Tang Zi Shui Qing Gan Yin Zuo Gui Wan Zuo Gui Yin With Fire Flaring: Zhi Bai Di Huang Wan With Liver Yang Rising and Wind: Ling Yang Jiao Tang
Points	KI-3, LIV-3, SP-6, UB-18, UB-23

KIDNEY YANG DEFICIENCY

Clinical Manifestations	Paralysis Slight edema of the dorsum of the feet Lumbago: low back feels cold, weak and aching Feeling chilled Aversion to Cold Cold limbs General debility Fatigue Lack of strength spontaneous sweating Pale face Urinary frequency with abundant, clear urine or Oliguria with edema Maybe nocturia Lassitude Withdrawn, subdued behavior Knees feel cold and aching Dizziness Vertigo Tinnitus Impotence Spermatorrhea Premature ejaculation Low libido Female infertility ("uterus cold and infertile") Maybe anorexia Maybe loose stools Maybe chronic diarrhea or "cock crow" diarrhea T: Pale and swollen C: Thin and white P: Deep and thready - maybe slow
Treatment Principle	Warm and Reinforce Kidney Yang
Herb Formulas	Lu Jiao Jiao Tang modified Jin Gui Shen Qi Wan You Gui Wan You Gui Yin
Points	Moxa or moxa needle DU-3, DU-4, KI-7, UB-23 For abdominal distention and fullness: + KI-20 For daybreak diarrhea: + Moxa REN-8 For enuresis: + REN-4 For clear, thin vaginal discharge: + SP-6 Moxa or moxa needle DU-4, KI-3, REN-4, UB-23 For chronic diarrhea, rectal prolapse and Vanquished Yang: + moxa DU-20, REN-8 For Kidney Yang Deficiency (Cock Crow) Diarrhea: moxa or moxa needle DU-20, KI-3, REN-4, UB-23

QI AND YANG DEFICIENCY WITH BLOOD STAGNATION

Clinical Manifestations	Hemiplegia Paralysis Atrophy of the lower limbs Facial paralysis Slurred speech Drooling Dry stools Frequent urination Urinary incontinence Deviation of the eyes and mouth Excess salivation Cold extremities Asthenia T: Purple and dark C: White and slimy P: Slippery, slightly slow and forceless
Treatment Principle	TonifY Qi Activate the Blood Unblock the channels Promote movement in the limbs
Herb Formulas	Bu Yang Huan Wu Tang modified
Points	DU-16, DU-20, LI-4, SP-6 For Kidney Deficiency: + KI-3, UB-23

BLOOD STAGNATION DUE TO WIND-COLD WITH QI DEFICIENCY

Clinical Manifestations	Facial paralysis Relatively superficial numbness without pain Paresthesia and numbness of the skin and flesh Paresthesia of the shoulders Neck and shoulder stiffness and pain Abdominal pain alleviated by warmth and pressure Pale complexion Hemiplegia Stiff tongue Flaccidity if the extremities Migratory pain Pain, weakness, tightness or spasms of the extremities Spontaneous sweating Shortness of breath Aphasia Excess salivation Aversion to Wind T: Normal or Thick C: White or Smooth and white or White and greasy P: Faint, choppy and tight or Slightly rough and tight or Large and weak or Slow and large
Treatment Principle	Tonify Qi and Blood Warm and harmonize the channels and collaterals Harmonize the Ying and Wei Unblock painful obstruction Warm the Middle Jiao Dispel Cold Alleviate pain Harmonize Yin and Yang
Herb Formulas	Huang Qi Gui Zhi Wu Wu Tang
Points

BLOOD STAGNATION DUE TO QI DEFICIENCY

Clinical Manifestations	Hemiplegia Sluggish speech Urinary incontinence Atrophy of the extremities Deviated mouth and eyes Salivation Frequent urination
Treatment Principle	Tonify Qi Invigorate the Blood
Herb Formulas	Bu Yang Huan Wu Tang Sheng Yu Tang With Blood Deficiency: Tao Hong Si Wu Tang
Points	General points

WIND-PHLEGM (FENG TAN)

Clinical Manifestations	Facial paralysis One-sided facial paralysis Facial muscle spasms or tics Paralysis Numbness Slurred speech Deviated eyes Deviated mouth (wry mouth) Dizziness Tinnitus Sputum in the throat Chest fullness and distention Epigastric fullness and distention Hypertension Stroke T: Deviated and trembling C: Thick P: Slippery and maybe wiry
Treatment Principle	Resolve Phlegm Subdue Wind
Herb Formulas	Ban Xia Bai Zhu Tian Ma Tang Yu Zhen San Qian Zheng San modified
Points	Pre-stroke: ST-40, UB-40 Stroke (emergency): DU-26, KI-1, PC-9, Ting Points Post-stroke: Arm: LI-4, LI-11, LI-15, SI-3, SJ-5 Leg: GB-34, GB-35, UB-40, UB-60 Scalp: Motor area (contralateral - upper one-fifth)

DAMP-PHLEGM (SHI TAN)

Clinical Manifestations	Dizziness Vertigo Mental cloudiness Heavy head Heavy sensation in the body Cough with Excess sputum Chest and epigastric distention Suffocating sensation in the chest and epigastrium Nausea Profuse sputum Vomiting Anorexia Fatigue Borborygmus Tinnitus Mouth glutinous No thirst Likes to sleep Maybe palpitations T: Thick C: White and greasy or Sticky and white P: Rolling or Wiry and slippery
Treatment Principle	Strengthen the Spleen Harmonize the Stomach Eliminate Dampness Resolve Phlegm
Herb Formulas	Ban Xia Bai Zhu Tian Ma Tang
Points	GB-34, LIV-13, REN-12, ST-36, ST-40 PC-6, REN-12, ST-8, ST-40, UB-20 DU-20, DU-23, GB-20, GB-34, LI-4, REN-12, ST-36, ST-40, ST-41 REN-12, PC-6, ST-41

PHLEGM-HEAT WITH WIND-PHLEGM

Clinical Manifestations	Sudden heaviness Numbness or paralysis of the extremities on one side of the body Facial paralysis Dysphagia Disordered consciousness Dry stools Constipation Dizziness Copious Phlegm Drooling T: Stiff and quivering or Deviated C: Greasy and yellow P: Wiry and slippery
Treatment Principle	Expel Phlegm-Heat through the bowels
Herb Formulas	Xing Lou Cheng Qi Tang Chinese Patent Medicines: Niu Huang Qing Xin Wan Niu Huang Jiang Ya Wan Jiang Ya Wan Jiang Ya Ping Pian Xiao Huo Luo Dan Tian Ma Wan Ren Shen Zai Zao Wan Da Huo Luo Dan
Points	Anmian, GB-20, GB-21, GB-31, GB-34, GB-39, GB-41, LI-4, LI-11, LIV-2, LIV-3, PC-6, SJ-5, ST-36, ST-40, Yintang Threading technique with a 3 inch needle ST-6 to ST-4 and ST-7, with a 1.5 inch needle ST-2 to ST-4 on the affected side, electroacupuncture connected to one of the facial points and LI-4 or LU-7 With eye affected: + SJ-23 With nose affected: + LI-20 With tongue affected: + REN-23 With lips affected: + DU-26, REN-24 For chronic cases: + moxa Ear: Apex, Lower Blood Pressure Groove

WIND PREDOMINANT BI

Clinical Manifestations	Facial paralysis Migrating pain in the joints especially the : Shoulders Elbows Knees Wrists Fingers Upper back and neck Multiple joints Pain quality changes May move from soreness to numbness to aching Sensitivity varies Pain often appears abruptly, acutely or paroxysmal and then disappears Limited range of motion Chills and fever Aversion to Wind Symptoms are worse in windy weather Sore throat General body aches Maybe perspiration T: Pink C: Thin and white or Sticky and yellow P: Superficial and moderate
Treatment Principle	Eliminate Wind Warm Cold Expel Damp Clear the Channels
Herb Formulas	Da Qin Jiao Tang modified
Points	DU-14, GB-39, SJ-6 With a fever: + LI-11 With deformities: + UB-11 To disperse Qi and relieve external symptoms: LI-4, UB-12, SJ-5, GB-31 GB-20 or GB-41, DU-1, LI-11, ST-36, UB-40 or UB-17, SI-12, DU-16, GB-20, UB-12, SJ-17, SP-10, GB-31 or DU-20, GB-20, GB-30 + General points

WEI SYNDROME DUE TO LUNG HEAT WITH FLUID DEFICIENCY

Clinical Manifestations	Flaccidity Atrophy Hysterical paralysis Periodic paralysis Facial paralysis Fever during the initial stage of an illness or Fever followed by weakness, rapidly developing flaccidity and immobility of the extremities with muscular atrophy, and dry skin Low grade fever and Yin impairment Usually lower extremities Dry skin Restlessness Irritability Thirst Cough A dry throat Scanty sputum Scanty, yellow urine Dry stool T: Red C: Yellow and scanty P: Thready and rapid
Treatment Principle	Clear Heat from the Lungs Moisten the Lungs Nourish the tendons and bones
Herb Formulas	Qing Zao Jiu Fei Tang modified Sha Shen Mai Men Dong Tang Sheng Mai San In cases where fever is abated with loss of appetite and severe dry mouth and throat due to Lung and Stomach Yin Deficiency: Yi Wei Tang
Points	General points + LU-5, UB-13 KID-3, KID-6, LU-5, LU-7, REN-4, REN-6, SP-6, ST-36 Huatuojiaji, LI-11, LU-7, LU-9, ST-37 For Lung Dryness: KID-6, LU-7, UB-23 DU-14, KI-3, LU-5, SP-6, ST-34, ST-36, ST-45 Arm: LI-4, LI-11, LI-15, SJ-5 Leg: GB-30, GB-34, GB-39, LU-5, ST-31, ST-36, ST-41, UB-13

WEI SYNDROME DUE TO DAMP-HEAT IN THE SPLEEN AND STOMACH WITH QI AND BLOOD DEFICIENCY

Clinical Manifestations	Heaviness of the limbs Weak and flaccid extremities Occasional numbness Hysterical paralysis Periodic paralysis Facial paralysis Slight swelling in the affected extremities Most often affects the lower extremities Possibly fever Stifling sensation in the chest and epigastrium Obesity Edema Skin problems Dark, scanty, painful and difficult urination A sensation of Heat that begins at the dorsum of the foot and slowly progresses up the leg to the waist T: Red C: Yellow and greasy P: Soft and rapid and possibly slippery
Treatment Principle	Clear Heat Dry Dampness Open the channels
Herb Formulas	Jia Wei Er Miao San modified Si Miao Wan modified Wu Wei Xiao Du Yin Yi Yi Ren Tang Dang Gui Nian Tong Tang
Points	General points + SP-9, UB-20 DU-8, DU-14, GB-34, LI-4, LI-11, SP-9 Huatuojiaji, LI-4, LI-11, SP-9, ST-31 to ST-41 With digestive problems: + REN-12, ST-44 DU-14, GB-31, LI-4, LI-11, SP-9 , ST-32, ST-36

WEI SYNDROME DUE TO SPLEEN AND STOMACH QI DEFICIENCY

Clinical Manifestations	Gradual onset of flaccidity and weakness of the extremities aggravated by exertion Gradual loss of muscle mass Hysterical paralysis Periodic paralysis Facial paralysis Sallow complexion Facial puffiness Fatigue Lassitude Anorexia No desire for food and drink Frequent belching Borborygmus Loss of sensation of taste Four limbs feel tired and heavy Abdominal and epigastric distention after eating Maybe acid regurgitation or vomiting Loose stools Shortness of breath Urine clear and abundant T: Pale and flabby - may have teethmarks C: White P: Even, forceless and Deficient or Thready and forceless
Treatment Principle	Tonify and Strengthen the Spleen and Stomach Augment Qi
Herb Formulas	Shen Ling Bai Zhu San modified Shi Quan Da Bu Tang Gui Pi Tang With Blood Stasis: Bu Yang Huan Wu Tang For obesity with excessive Phlegm: Liu Jun Zi Tang For significant Qi Deficiency or Qi Sinking: Bu Zhong Yi Qi Tang Chinese Patent Medicine: Ba Xian Tang
Points	General points + REN-4, REN-6, SP-6, ST-36, UB-20, UB-21 REN-12, SP-6, UB-20 DU-5, DU-6, LI-10, ST-36, UB-20, UB-21 LIV-13, REN-6, REN-12, SP-3, SP-5, SP-6, ST-21, ST-36, UB-20, UB-21 Huatuojiaji, REN-6, SP-6, SP-9, ST-31 to ST-41 For vertigo: + DU-20, GB-20 DU-3, LIV-13, REN-12, SP-3, ST-31, ST-36, UB-20, UB-21

FENG TAN (WIND-PHLEG)

Clinical Manifestations	Facial paralysis Numbness Slurred speech Deviated eyes Deviated mouth (wry mouth) Dizziness Tinnitus Sputum in the throat Chest fullness and distention Epigastric fullness and distention Hypertension Stroke T: Deviated and trembling C: Thick P: Slippery and maybe wiry
Treatment Principle	Resolve Phlegm Subdue Wind
Herb Formulas	Ban Xia Bai Zhu Tian Ma Tang With Phlegm-Heat: Xing Wei Cheng Qi Tang
Points	Pre-stroke: ST-40, UB-40 Stroke (emergency): DU-26, KI-1, PC-9, Ting Points Post-stroke: Arm: LI-4, LI-11, LI-15, SI-3, SJ-5 Leg: GB-34, GB-35, UB-40, UB-60 Scalp: Motor area (contralateral - upper one-fifth)

FACIAL PARALYSIS

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