Facial paralysis

Today, I saw a patient with facial paralysis. I asked her to smile for me first. Not bad, I could see her teeth. This indicates that her condition isn’t too severe. She told me that shortly after the onset of her symptoms, she sought acupuncture, massage, and a traditional Chinese medicine practitioner who prescribed over twenty days of herbal medicine. As a result, she is now recovering quite well, although she still feels numbness and some pain in certain areas of her face. I’m glad that the patient was knowledgeable enough to seek a TCM acupuncturist when she realized something was wrong. I’m also pleased that the TCM practitioners who treated her were skilled, which contributed to her good recovery. Therefore, I can confidently say that if you experience facial paralysis, you should quickly consult a TCM acupuncturist rather than relying on anti-inflammatory drugs from Western medicine.

How does TCM view facial paralysis? I remember treating a young Tibetan man who told me that the night before his symptoms appeared, he had drunk heavily and slept outside. When he woke up, half of his face felt numb, and he couldn’t move it when he looked in the mirror. Another patient told me that he often drove with the air conditioning blowing on his face, and wondered if that was why half of his face became paralyzed. I also remember a middle-aged woman who said she hadn’t done anything unusual, but one morning her husband noticed that half of her face wouldn’t move. All these cases were caused by exposure to wind. We have several meridians on our face, and facial paralysis commonly involves the stomach meridian.

How can acupuncture and herbal medicine be used to treat facial paralysis? First, I always ask the patient to smile. This simple action reveals a lot; it’s not about checking how white their teeth are, but determining which side of their face is affected. Facial paralysis usually affects only one side. Then, I ask them to close their eyes. This serves three purposes: first, to check if the eyelids are affected, since severe cases might prevent the eyelid from fully closing, indicating that the disease affects not just the yangming stomach meridian but also the shaoyang meridian, which governs opening and closing. Second, to avoid scaring the patient when I use a three-inch needle to puncture from the corner of their mouth to the angle of their jaw. Knowing this could frighten them. Third, because I need to insert a needle near their inner eye corner, which I can’t do if their eyes are open.

Patients often tell me their face feels numb, warm, or painful in some areas, and some even experience headaches. I say that wind can be quite terrifying as it is often the root cause of diseases. When wind affects a specific meridian or organ, problems arise in that area. I advise people to bring an extra piece of clothing or wear a hat to protect the back of their head when going out, as there are two acupoints, Fengfu and Fengchi, related to wind.

In terms of herbal medicine, Kudzu root (Ge Gen) is essential because its properties move upward, bringing the medicinal effects to the head and face. Kudzu root can elevate yang and relieve muscle tension, and its sweet and spicy nature helps dispel wind. If the patient’s constitution includes damp heat, we also add Huang Qin and Bai Zhu. Otherwise, Kudzu root might carry damp heat to the head, potentially causing facial swelling. Therefore, prescriptions must be carefully tailored, and additional herbs for tonifying qi and blood may be needed for patients with qi and blood deficiencies. This is how prescriptions are formulated.

Patients typically see significant improvement after one to three treatments. I enjoy treating facial paralysis because you can visibly see the gradual changes in the patient’s face. How do I check progress? I ask them to smile in front of a mirror. If the once immobile side of their face begins to show teeth, it’s a clear sign of recovery. Some patients, however, not only experience facial numbness but also overall nerve numbness after a stroke. Even when they are improving, they might not feel it and start complaining that herbal medicine is ineffective or that TCM is useless. This can be quite frustrating and leaves me at a loss for words.