Bell’s Palsy…a Case Study

Have you ever had Bell’s Palsy? Have you ever treated it?

Bell’s Palsy is a vexing condition for practitioners and a scary one for patients. It’s also a common condition for both acupuncturists and Western practitioners to treat, and it tends to respond well to TCM treatment.

Although TCM is a lot more interesting to me than Western medicine, it’s important to understand how Western doctors think about Bell’s Palsy. Most patients will be seeing both you and their MD for treatment. While the MDs won’t have a clue about your way of thinking, I think it’s important for us to know about theirs. Patients will appreciate the effort you put into understanding the bigger picture.

A Western Analysis

What is Bell’s Palsy? It’s a condition affecting the facial nerve, in which muscles on one side of the face go weak or limp. It can be pretty scary for the patient because a lot of the symptoms look similar to a stroke. Beyond facial paralysis the patient may notice tingling in the face, eye twitching, inability to blink the eye, headache, neck pain, memory problems, and even balance problems. Because the facial nerve affects tear ducts and saliva production, the patient will likely have a dry eye and may have a diminished ability to fully taste food.

The doctor will do a series of exams to diagnose Bell’s Palsy and rule out stroke. Once Bell’s Palsy is officially diagnosed, the severity is based on a scale from I to VI–ranging from normal facial function to total paralysis. Then comes the “cookbook” list of prescriptions: prednisone, antiviral medications, over-the-counter pain medications, eye drops, and an eye patch. The suggested natural approach to treatment includes warm towels and/or facial massage for pain relief.

It is not abnormal to have some lingering symptoms a year after diagnosis and treatment.

A TCM Analysis

The reason acupuncture is so effective is because we focus on the underlying cause of the disease and treatment of the specific acupuncture channels related to the condition. TCM patterns related to Bell’s Palsy include internal wind which may be caused by Liver Wind, Liver Yang Rising, Extreme Heat, and/or Blood Deficiency. Treatment includes underlying TCM pattern differentiation AND channel pathway disharmonies. Typical treatment modalities include needle and electrical stimulation of channel pathways, Chinese herbs and dietary therapy.

Prognosis is BEST when treatment is aggressive within the first week. Early, and consistent treatment, during the acute phase of Bell’s Palsy helps narrow the possibility of the lingering 25% who still have symptoms a year later.

Awhile ago I wrote a blog series about Bell’s Palsy, which gets into a lot of details. This series was written in a voice specific to educating patients. I included the links here so you could refer back to them later.

Today’s blog includes NEW strategies which I am now using in my clinic involving a specific way to treat the CHANNEL.

New Treatment Strategies

How quickly you treat Bell’s Palsy makes all the difference in the world. I’m sure you have had questions like this throughout your career as an acupuncturist: “Can you help my Bell’s Palsy symptoms that never resolved?”  Unfortunately, I’ve found acupuncture isn’t very good at fixing long-standing Bell’s Palsy symptoms. BUT if I can treat the problem when it first appears, I get great results.

As you know, I use multiple diagnostic and treatment tools in my clinic. If a tool brings better results than traditional TCM tools, I add it to my toolbox.

Having the right tools available for acute Bell’s Palsy care is an absolute necessity. In the past, I’ve always had these tools available:

  • A really good protocol. The resources section of AcuGraph has a fantastic protocol for Bell’s Palsy including points such as TE 17, GB 14, Tai Yang, SI 18, ST 7, ST 4, ST 6 and LI 4.
  • A microcurrent treatment device. I use a four channel device from Pantheon.
  • A treatment plan that is effective. I recommend three times a week at the onset of Bell’s Palsy, then twice a week for the third week, then weekly until symptoms resolve.
  • An herbal formula which fits the TCM pattern diagnosis–Liver Wind, Liver Yang Rising, Extreme Stomach Heat, and/or Blood Deficiency.

These tools are absolutely necessary for effective traditional Chinese Medicine.

But are they enough? They were until now…

Then I discovered something NEW and AMAZING.

Here’s what happened…

*****

Case Study: Acute Onset Bell’s Palsy

Patient: 38-year-old female; information and pictures used by permission.

Diagnosis: Right-sided Bell’s Palsy.

Bell's Palsy Day 1Day 1

Onset: 

*Two days prior to recognizing symptoms, the patient was diagnosed with mononucleosis.

The patient awoke in the morning and recognized numbness in her face and jaw. She had trouble brushing her teeth or drinking water. She also recognized a metallic taste in her mouth and a diminished ability to smell. Initially, she thought she was having an allergic reaction.

Diagnosis and Treatment with the MD:

Her MD diagnosed her with Bell’s Palsy, which she had never heard of.

She was prescribed steroids and an antiviral medication. He told her that some people have improvement within two weeks and others take several months. He warned her that her eye and forehead would probably begin to droop and that she may not be able to drive or close her eye at night.

Over the next few days, the symptoms progressed to the inability to blink her eye, pain in the jaw and around the ear, headache, earache, and general dizziness.

After the initial 7-day dose of steroids, she still felt terrible, so she went back to her MD. He prescribed more steroids.

Her doctor never suggested acupuncture as a treatment modality, but a friend did…

Two things should stand out to you here that involve community education. First, her doctor didn’t send her to an acupuncturist. We should spend time educating the medical community on ways we can help their patients.

Second, because she was an acupuncture patient, she should have known about Bell’s Palsy and the urgency of receiving treatment right away. (Luckily, her friend educated her quickly.)

I take responsibility for that. I should have sent out a blog to my patients to educate them on this subject.

 

Days 4, 6, 8, 11, and 13

Acupuncture Treatment: Acupuncture with microcurrent to the face following standard Bell’s Palsy protocol to TE 17, GB 14, Tai Yang, SI 18, SI 19, ST 7, ST 6, and LI 4. Also included various points for yin channel deficiencies and emotions which were chosen on a per-treatment basis.

Progress: Daily, progressive changes with forehead, smile and frown. Eye still not blinking. Forehead was moving a little. With two weeks of aggressive microcurrent treatment she reached 25 to 35% improvement.

When she arrived for treatment on Day 14, she was in tears. Progress was slow. She was tired and overwhelmed. The thought of laying with needles twitching in her face was too much to bear that afternoon. So I decided to change things up. 

I’d been experimenting with the AAH Light for other conditions–using the blue to sedate/resolve inflammation, and the red to tonify/promote tissue healing–so I decided to try using the AAH Light on the treatment of her Bell’s Palsy that day. 

Days 14, 15, 19, 21, 26 and 33

Bell's Palsy Facial NerveAah Light Treatment: 

My goal was to resolve inflammation and promote healing in the nerves and muscles related to her facial paralysis. Here’s what I did:

  • Step 1: Facial massage with oil.
  • Step 2: Treatment of acupuncture points on the face with the Blue AAH Light for 20 seconds each.
  • Step 3: Trace the facial nerve distribution pathways from the ear to the face with the blue AAH Light. (With skin contact) About 5 minutes total.
  • Step 4: Treatment of acupuncture points on the face with the Red AAH Light for 20 seconds each.
  • Step 5: Repeat step three with the Red AAH light.

Note: When doing steps three and five, my hand holding the AAH Light would naturally stop at areas which were “stuck.” I worked these “stuck areas” in clockwise circles with a “surround the dragon” type of approach to clear the blockage. By the end of the 5-minute treatment, the light moved smoothly over the nerve distribution on the face.

Progress:

  • On Day 19 my patient came into the office with a BIG (somewhat crooked) smile on her face. She was extremely happy because FINALLY she was noticing real progress.
  • Day 21: Continual expedited progress. Seeing significant changes daily.
  • Day 26: Facial paralysis has improved by 80%.
  • Day 33: Improvement of 95%. (NOTE: She continued weekly treatment after Day 33.)

Bell's Palsy Progress

 

*****

This case study wasn’t planned. Bell’s Palsy never is, right? It just kind of shows up unannounced.

If I could give you any advice for successful treatment of Bell’s Palsy it would be this…

#1: Educate your patients and your community so they know WHEN to come to see you. Time is of the essence. (That series of blog posts I shared up top will come in handy here.)

#2: Have the right tools. Don’t  wait until a Bell’s Palsy patient walks through the doors of your clinic to be prepared. Know your protocols and your tools. I am now using the AAH Light for a lot of conditions in my clinic. When the next Bell’s Palsy patient walks through the door, I’ll be prepared to combine AAH Light therapy into my treatment strategies from the start, instead of waiting two weeks to begin the AAH Light treatment.

Thanks for reading! I hope my experience helps you. If it works, I share it.

Until next time…

~Kimberly

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Kimberly Thompson, L.Ac.

Acupuncture Research Analyst

Miridia Technology

kimberly@miridiatech.com

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Kimberly Thompson, L.Ac.

Kimberly began her 2nd career when she earned her Masters of Science degree in traditional Oriental Medicine from Pacific College of Oriental Medicine in San Diego, CA in 2008. Today she is a Chinese Medicine practitioner specializing in acupuncture, Chinese herbs, and massage therapy. Kimberly treats the root of the disorder through an energetic approach that balances physical and emotional aspects of the patient. Credentials • Masters of Science – Pacific College of Oriental Medicine. • Kimberly is a licensed acupuncturist in the state of Idaho. • NCCAOM certified. • Member of the Idaho Board of Acupuncture.

10 thoughts on “Bell’s Palsy…a Case Study

  1. Acupuncture does wonders in Bell s Palsy, One of my Patient suffered from Bells Palsy on Friday and she came to me on Monday. When she visited my clinic she had terrible pain behind the ear , drooping of left eye and face muscles, right eye was completey open and has no feeling on right side. she was on steriods and antiviaral drugs. First treatment was on Monday and by Friday she was recovered 75-80 %. Even her medical doctor was surprised. within Two weeks she was recovered more than 90%.. Thanks
    Sarabjit Romana
    604 764 0793

    1. Her first round of steroids lasted for 7 days and the second round lasted for 5 days. I’m not opposed to using both Eastern and Western approaches toward treatment. I don’t think the western meds necessarily opposed treatment. I do think in this case it was a harder case to treat because we were also dealing with mono. It’s hard to say if the steroids and anti viral medications “opposed” treatment. Most patients I see with Bell’s Palsy are using the typical western drugs during treatment and it hasn’t been oppositional in the past.

    1. I’m away from office for the next several days. I’ll look when I get back in town. From the top of my head I know I did 30 minutes of alternating current. That’s all I can remember at the moment! Stay tuned… 🙂

So, what do you think about it?