Bell's palsy is a form of facial paralysis resulting from a dysfunction of the facial nerve that results in the inability to control facial muscles on the affected side.

Bell's palsy is a paralysis or weakness of the muscles on one side of the face. Damage to the facial nerve that controls muscles on one side of the face causes that side of the face to droop.

Bell's palsy pertains to deviated eye and mouth, or deviated mouth in TCM. It is mainly the result of loss of nourishment to the sinew, and is usually caused by wind invading the facial collateral obstructing the meridian qi to the face, or qi and blood deficiency giving rise to obstruction of a pathogen in the meridian and collateral.*

This disease can be divided into two pattern types in TCM as listed in Fig. 17-11.

Pattern of wind invading the collateral* is marked by sudden appearance of deviated eye and face, loss of facial expression of the affected side, numbness, or pain in the back of the ear, or aversion to cold, fever, thin and white tongue fur, and floating and tense or floating and rapid pulse.

Pattern of pathogen obstructing the collateral due to deficiency of qi and blood* is characterized by deviated eye and mouth after a prolonged illness, loss of facial expression on the affected side, even facial tic, or difficulty in opening and closing the eye, pale tongue and fine pulse.

Acupuncture is very helpful for this paralysis. The common acupoints for Bell's palsy are fengchi (GB20), jiache (ST6), dicang (ST4), hegu (LI4) and taichong (LR3). Add yifeng (TE17) if there is pain behind the ear; add yangbai (GB14) and cuanzhu (BL2) if the patient is not able to close the eye; add yingxiang (LI20) for the patient whose nasolabial groove* has disappeared; add shuigou (GV26) for nasolabial groove deviation; add chengjiang (CV24) for deviated mentolabial furrow*; and add zusanli (ST36) if the disorder has been going on for a long time.

Insert the needles transversely to each other for jiache (ST6) and dicang (ST4) and needle yangbai (GB14) transversely downward. Facial acupoints are required to be needled with neutral supplementation and draining method, and fengchi (GB20) is usually needled with twirling draining method in this case. Use draining method for hegu (LI4) and taichong (LR3) and supplementation method for zusanli (ST36). Moxibustion can be applied on ST36 and needling in the early stage should be mild.

Electro-acupuncture* is recommended for Bell's palsy; acupoints jiache (ST6), dicang (ST4), yangbai (GB14) and sibai (ST2) are commonly chosen. After qi arrival by manual manipulation, electro-acupuncture can be applied for 10 to 20 minutes. Adjust the frequency of stimulation to mild tic of the facial muscles. Electro-acupuncture can be performed once a day or once every other day.