Bell's facial paralysis is one of the commonest peripheral facial paralyses which occurs suddenly and mostly after exposure to cold wind. 85¡ª90% of the patients get recovered spontaneously. If falls into the category of "zhen zhong feng" (true wind-stroke) in TCM.  

Main Points of Diagnosis

1. It often occurs in autumn and winter or between spring and summer, mostly in the middle-aged. The disease usually attacks one side of the face.

2. The attack comes all of a sudden. At the beginning the patient feels numb at one side of the face, pain around the ear and tenderness in the mastoidale region. The mouth becomes wry, the nasolabial groove no longer seen and the facio-buccal region relaxed and strengthless. It is impossible to have the cheeks blown up. The eyeballs are still exposed when the eyes are shut. It is difficult to frown and speak. Salivation comes down from the corners of the mouth. The sense of taste is lost but the sense of hearing is hypersensitive. 

Differentiation and Treatment of Common Syndromes  

1. Internal Treatment.

1) The Early Stage

Main Symptoms and Signs: The onset is sudden and the duration is short. The mouth and eyes become wry. The eyeballs can balls can always be seen as the eyes can not be closed entirely. There is difficulty in frowning. The accompanying symptoms and signs are headache, discomfort or low fever, red tongue with thin and white fur, and taut and thready pulse.

Therapeutic Principle: Dispelling pathogenic wind and removing obstruction from the channels.

Recipe: Yang-Clearing Decoction with additional ingredients (yang here means the upper regions of the human body, especially the face)

astragalus root

Chinese angelica root

tribulus fruit

cimicifuga rhizome

safflower

bark of Chinese corktree

cinnamon twig

sappan wood

ledebouriella root

cicada slough

pueraria root

licorice root

All the above ingredients are to be decocted in water for oral administration.

2) Late Stage.

Main Symptoms and Signs: The course of the disease is protracted. The mouth and the eyes become wry. No wrinkles can be seen on the forehead. The patient has reddish tongue with petechiae on it, thin and white fur, and thready and feeble pulse.

Therapeutic Principle: Promoting qi flow and blood circulation, removing phlegm and clearing away obstruction from the channels.

Recipe: Powder for Treating Wry-mouth, compounded with Decoction Invigorating Yang for Recuperation

giant typhonium tuber

scorpion

batryticated silkworm

peach kernel

safflower

earthworm

astragalus root

tip of Chinese angelica root

ligusticum root

red peony root

All the above ingredients are to be decocted in water for oral administration.

For those running low fever, add 30 grams of isatis root and 30 grams of honeysuckle flower. For those with restlessness (due to deficiency) and palpitation, add 18 grams of prepared rehmannia root and 18 grams of prepared fleece-flower root. for those who feel fullness and suffocation in the chest and stomach and who are fat and have much sputum, add 6 grams of arisaema with bile and 9 grams of pinellia tuber.

2. External Treatment

1) Apply adhesive plaster on the acupoints: Dust 0.5-1 grams of nux-vomica seed powder onto a plaster and then apply the plaster on the acupoints of Taiyang (Extra 2), Xiaguan (St 7) and Jiache (St 6) of the affected side (more applicable to the regions with tenderness). Change the plaster every 3 days. If blisters appear on the administered part, extract its fluid after disinfection. Then the blisters will get cured spontaneously.

2) Smear the blood of eel onto the affected region: Smear fresh blood of eel onto the buccal skin of the affected side, and hold the mouth angle of the affected side with a metal hook so as to help cure the facial paralysis. This is to be done once a day.

3) Do local massage on the affected region, several times a day.

4) Acupuncture therapy for this trouble can get a better result.  

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