Facial Paralysis: My face is drooping, can Acupuncturist Help?
Is it a stroke, Bell’s Palsy, or a virus attack?
“Doctor, my face suddenly look smashed when I woke up in the morning and I couldn’t control it at all! The eye isn’t blinking completely, causing this redness and tearing eye. My speech sounds sluggish and I’m drooling without control. I felt so embarrassed and dysfunctional, What should I do?”
I often encounter this type of conversation during the change of season, particularly from Winter to Spring, and Summer to Autumn. When I was still an intern during my medical internship in school clinic, the first and the most impressive case was facial paralysis. The patient was not only suffering from Bell’s Palsy, she also had Botox (Botulinum toxins, BTX) done on her face at the side of Bell’s Palsy. She was more concern of the symmetry of her face at the beginning since it’s been a frequent attack for her case; thus, she sought for Botox treatments before reaching Acupuncturist for recovery. With the popularity of Cosmetic and Plastic Surgery, there have been more and more cases of facial nerve lesions caused by botulinum toxins on the face. Though the lack of facial expression caused by Botox may be treated with Acupuncture to reduce the severity of muscle spasm and paralysis, we will be discussing other common cause of Facial paralysis such as Stroke, Bell’s Palsy, or Virus in this article.
Facial paralysis usually occurs unilateral, and Bell’s Palsy is a type of Facial nerve paralysis around the peripheral nervous system (PNS). Facial paralysis also occurs when facial nerves become inflamed or infected. The cause of Bell’s palsy is still unknown, and a small number of patients are infected with the virus. Therefore, most of the acute phase of Bell’s palsy are treated with steroids prescribed by the Medical doctor at the beginning. And when there’s pain behind the ear or some herpes virus symptoms, the doctor will prescribe antiviral drugs to shorten the course of symptom. Most patients with facial paralysis usually will slowly regain normal facial expression after three to six weeks. A small number of patients with sequelae will be further recommend for physical therapy to reinforce restoring the normal facial muscle function.
It’s also a Key sign of stroke, how to distinguish?
Stroke, defined in Western medicine, is the phenomenon of blood flow blockage in the brain, resulting in hypoxia and cell necrosis. It is divided into cerebral thrombosis infarction (Ischemic), cerebral hemorrhage due to vascular rupture, and transient cerebral ischemia (TIA).
The facial paralysis from stroke is controlled by the central nervous system (CNS), rather than a single peripheral facial nerve attack. So when there’s a stroke attack, Left lower half face or right lower half face along the jaw line, and the same half side of the extremities: hand and/or foot will also be paralyzed. And if it’s not recognized timely, patient may not be able to move around freely on their own due to a large region of paralysis.
The limbs of patients with Bell’s palsy are usually unaffected because only the facial nerves are inflamed; affecting from the forehead to the edge of the mouth, and rarely down to the neck or upper limbs. In addition, the wrinkles on the forehead will also become invisible or less due to the paralysis. On the contrary, stroke patients may still squeeze their forehead with wrinkles on the affected side, and they are able to close their eyes completely most of the time. However, the vast majority of patients can not distinguish between the two. Whether it is a stroke or Bell’s palsy, patient should always seek a medical profession timely for treatment.
The critical timing of stroke treatment is within maximum of three hours after the onset of symptoms; and although Bell’s palsy may seem relatively safe, it should also be treated timely within 72 hours at least, after the onset of symptoms which does not seems to disappear.
Facial paralysis caused by Virus
Virus may be the cause for some facial paralysis, and the most common one is Herpes Zoster. And yes, Herpes Zoster usually attacks our body when the immune system is weaken. The symptoms will travel along the nerve fibers, and results in Shingles on your skin; or the face, in this case, we are taking about the Facial Paralysis caused by the Herpes Zoster. The key symptoms include facial paralysis, earache, and the external ear canal redness/ rashes/ or possibly blisters; it’s called Ramsay Hunt Syndrome. Another atypical herpes facial paralysis: Zoster Sine Herpete Facial Palsy, instead of visible rashes around the ear, the earache is much more prominent. This is often misdiagnosed as Bell’s Palsy, and there are news shows that it is more common in young adults.
After distinguishing the 3 common cause of facial paralysis, what do Chinese medicine practitioners think? How Can an Acupuncturist help?
In Mandarin Chinese speaking, the Stroke (中風, ZhòngFēng) is characterized and pronounced the same as one of the cause for facial paralysis in Traditional Chinese Medicine (TCM) : Wind Pathogen Invasion, 中風 ZhòngFēng, where 風 Fēng means the Wind Pathogen. For Chinese Medicine Practitioner/ Acupuncturist, most of the facial paralysis cases are often caused by the wind evil (風邪, the wind pathogen) and cold evil (寒邪, the cold pathogen). Oftentimes, the wind evil and cold evil invasion will result in symptoms of Common Cold, and it’s commonly seen in the spring and autumn seasons when the temperature differs drastically in day and night.
Since the cause of facial paralysis in mainstream medicine is still unknown, most patients we seen in the clinic with acute attacks, often has a recent history of cold and frequent excessive exhaustion relate to stress. With wholistic approach, traditional Chinese medicine practitioner not only help reduce the facial paralysis symptoms through acupuncture, but also differentiate patient’s body type to treat the underlying root problem.
Emotion, Diet, and Lifestyle
Chinese medicine believes that emotions, diet, and lifestyle are all part of health conditioning.
Long-term emotional depressed may cause Liver and Heart Qi Stagnation, and lead to Heat or even Fire in serious condition. When the body’s immune system is weak, the wind or cold pathogen will attack the body along the meridian, and result in the facial paralysis diagnosed as Liver Qi Stagnation with Heat or fire. This is similar to mainstream medicine diagnosis where the virus is attacking along the dermatome.
In terms of diet, facial paralysis may be a result of weak digestion and absorption. People with weak digestive system and metabolic system may not necessarily are slim in body-shape, many obese patients are actually weak in digestion and absorption. When there’s an irregular diet pattern, the spleen (metabolic system in TCM) cannot transport and transform healthily, and the accumulation of toxin will form dampness within the body. Excess or long-term dampness within the body will harm the immune system. The external pathogen are easily invade when the immune system is weak, and this type of facial paralysis is diagnosed as Spleen Qi deficiency with Damp or Damp Heat accumulation. The signs and symptoms are often similar to having a stomach flu.
Lastly, living habits such as staying up late, over-stress, long-term physical weakness, and/or chronic illness, may lead to pain. Without taking care of any body malfunction timely, the chronic illness, or Qi Deficiency in TCM, will result in Blood Deficiency. When the Qi (Energy) and the Blood (Nutrient) are not sufficient, the meridians flow are likely to be blocked. In TCM, “ When there’s a blockage, there’s pain.” This type of facial paralysis is diagnosed as Qi and Blood Stagnation or Stasis.
Since the symptoms of facial paralysis are often acute, it is recommended patients should seek Medical doctor for treatment as soon as possible. In order to shorten the course of the disease and to reduce the possible sequelae, patient should co-managed their symptom with a Chinese Medicine Practitioner/ Acupuncturist with Acupuncture and some Chinese herbal medicine treatment at same time. As we mentioned above, after differentiating the body type and underlying root cause in TCM, either it’s due to the Liver Qi Stagnation, Liver Heat/Fire, Spleen Qi Deficiency, Dampness/ Damp-Heat Accumulation, Qi and/or Blood Stagnation/ Stasis, all are not formed within two or three days. Having Acupuncture treatment will help speed up the process of regaining the normal facial muscle function while regulating and improving the body condition, and to prevent recurrence in the future.
Related news: “Angelina Jolie credits Acupuncture for her full recovery from Bell’s Palsy” in the cover story of Vanity Fair in September 2017.
More articles about Acupuncture written by Dr. Chang you may be interested to read: What is Acupuncture? , Pain Management with Acupuncture
