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(299) Bell's palsy

Started by HB KIM, Mar 29, 2010, 12:49 PM

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Definition:  Bell's palsy is named after the Scottish anatomist Charles Bell, who first described it.  It is defined as a sudden, idiopathic, unilateral peripheral 7th cranial nerve (the facial nerve) palsy.  Dysfunction of the facial nerve results in the inability to control facial muscles on the affected side.

Symptoms:  Sudden weakness or paralysis on one side of the face, droopy eyelid or corner of the mouth, drooling, excessive tearing or dry eye, loss of the ability to taste, pain in or behind the ear, numbness in the affected side of the face, and increased sensitivity to sound.

Cause:  Cause is unknown, but the mechanism is presumably swelling of the facial nerve due to an immune or viral disorder.  Bell's palsy affects about 2 in 10,000 people.  Many disorders cause facial paralysis, e.g. brain tumor, stroke, geniculate herpes, middle ear or mastoid infections, chronic meningitis, and Lyme disease. However, if no specific cause can be identified, the condition is known as Bell's palsy, and is commonly referred to as idiopathic.

Prognosis & Treatment:  In many cases, no treatment is needed.  About 60-80% of cases go away completely within a few weeks to months.  However, sometimes the condition results in permanent changes.  Doctors may prescribe corticosteroids (such as prednisone) if the cause is inflammation, or antiviral drugs (such as acyclovir) if it's caused by a virus.  Acupuncture, cupping, and herbal medicine can significantly improve results and help to resolve the condition.


TCM Points:
1. Primary points: ST4 & ST6, SJ17 & GB20, LI4 & LV3
2. Secondary points: LI20, LI19, DU26, RN24, GB14, ST2, ST3, KD6, Qian Zheng

Tung Points:
1. Treatment A:  Si Hua Wai (77.14), Ce San Li (77.22), Ce Xia San Li (77.23)
2. Treatment B:  San Zhong (77.07), Si Ma (88.17), Tong Shen (88.09)

Yin-Yang Balancing (Pyung-Chim):
1. Problem side: Tonify ST41, Sedate ST44
2. Healthy side: Tonify LI2, Sedate LI5

Bleed the cheek, inside the mouth on the affected side


1. Wind-Phlegm in the Channel: bell's palsy, acute onset, a thin-white tongue coating, and a floating-slippery pulse

6.0g  Bai Fu Zi (typhonium rhizome)
6.0g  Jiang Can (silkworm)
4.5g  Quan Xie (scorpion)
: 2-4.5g (decoction); 0.6-1g (powder)
6.0g  Bai Zhi (angelica root)
6.0g  Chuan Xiong (szechuan lovage root)

This formula is modified Qian Zheng San (Lead to symmetry powder).  This formula can treat bell's palsy, migraine, and hemiplegia due to Wind-Phlegm in the channel.  Bai Fu Zi can expel Wind and dissolve phlegm, especially in the facial area.  Jiang Can and Quan Xie both treat Wind and convulsions.  Jiang Can treats Phlegm better and Quan Xie opens the Channels better.  Bai Zhi and Chuan Xiong are good guiding herbs to the face and head area, and they both relieve Wind and Pain.  Taking these with warm liquor will improve the opening actions.

Note: Qian Zheng San (Bai Fu Zi, Jiang Can, Quan Xie) can be used as a basic formula if the pattern differentiation is unclear.  Try Qian Zheng San + Gui Zhi Jia Ge Gen Tang for early cases of bell's palsy.  If bell's palsy is over 3 weeks, try Qian Zheng San + Bu Yang Huan Wu Tang.

2.  Blood deficiency with Wind: bell's palsy, chronic, dizziness, insomnia, palpitations, a thin-white tongue coating, and a wiry-thready pulse

9.0g  Bai Shao (white peony root)
9.0g  Dang Gui (chinese angelica root)
9.0g  Shu Di Huang (prepared chinese foxglove root)
9.0g  Chuan Xiong (szechuan lovage root)
3.0g  Quan Xie (scorpion)
6.0g  Jiang Chan (silkworm)
6.0g  Di Long (earthworm)

This formula is modified Si Wu Tang (Four-substance decoction).  Si Wu Tang itself is more popular for gynecological diseases with Blood deficiency and Blood stasis.  General indications include irregular menstruation due to Chong/Ren deficiency, restless fetus syndrome, and postpartum lochia.  However, with Quan Xie, Jiang Can, and Di Long, it can address bell's palsy due to a blood deficient Wind pattern.

3.  Qi and Blood deficiency:  bell's palsy, slow recovery, fatigue, shortness of breath, a dark tongue color, and a thready-hesitant pulse.

120g  Huang Qi (milk-vetch root)
6.0g  Dang Gui Wei (tail of chinese angelica root)
4.5g  Chi Shao (red peony root)
3.0g  Di Long (earthworm)
3.0g  Chuan Xiong (szechuan lovage root)
3.0g  Tao Ren (peach kernel)
3.0g  Hong Hua (safflower)
3.0g  Quan Xie (scorpion)
4.5g  Jiang Can (silkworm)

This formula is modified Bu Yang Huan Wu Tang (Tonify the yang to restore five decoction).  Bu Yang Huan Wu Tang popularly used for sequela of stroke due to a deficiency pattern.  It addresses hemiplegia of a deficiency pattern with a large dosage of Huang Qi.  With Quan Xie and Jiang Can, it treats bell's palsy of the Qi and blood deficiency type.


Empirical Formula 1: Expel Wind and Move Blood
12g  Bai Fu Zi (typhonium rhizome)
9.0g  Jiang Can (silkworm)
4.5g  Quan Xie (scorpion)
15g  Sheng Di Huang (chinese foxglove root)
15g  Chi Shao (red peony root)
9.0g  Chuan Xiong (szechuan lovage root)
15g  Dang Gui (chinese angelica root)
50g  Sang Zhi (mulberry twig)
9g  Si Gua Luo (dried luffa sponge)
30g  Ji Xue Teng (spatholobus vine)

Empirical Formula 2:  Expel Wind and Calm Liver, Activate Blood and Open the Channels
9.0g  Dang Gui (chinese angelica root)
9.0g  Chuan Xiong (szechuan lovage root)
3p.  Wu Gong (centipede): 1-3g (decoction); 0.6-1g (powder)
6.0g  Chan Tui (cicada molting)
6.0g  Gan Cao (licorice root)
9p. Di Long (earthworm): fried
12g  Bai Fu Zi (typhonium rhizome)
12g  Fang Feng (siler root)
12g  Gou Teng (gambir vine)
12g  Jiang Can (silkworm)

Empirical Formula 3:  Expel Wind, Disperse Cold, Open the Channels
4.5g  Quan Xie (scorpion)
9.0g  Bai Fu Zi (typhonium rhizome)
9.0g  Jiang Can (silkworm)
9.0g  Chuan Xiong (szechuan lovage root)
9.0g  Jing Jie (schizonepeta)
9.0g  Fang Feng (siler root)
9.0g  Bai Zhi (angelica root)
9.0g  Qiang Huo (notopterygium root)
3.0g  Bo He (field mint)