Acupuncture has emerged as an alternative therapy for Bell’s palsy. Some patients suffer long-term and uneven recovery periods. Therefore, acupuncture interventions aim to promote recovery and minimize the risk of complications and long-term effects. In this article, acupuncture intervened two bell’s palsy cases, one was 34 weeks (about 8 months) pregnant, other was in 3 days postpartum, after acupuncture treatment their facial muscle's function were recovered in 1-2 months. Because some of Bell’s palsy is short-term and improves over weeks [1], the use of acupuncture is controversial. Further trials on pregnant and postpartum women with acupuncture for Bell’s Palsy should be explored; a double-blinded studies are necessary. Key word: Bell’s palsy; Acupuncture Bell's palsy is the most common disorder affecting the facial nerves and results in sudden weakness or paralysis on one side of the face with unclear etiology. Paralysis causes half of the face to appear drooping, distorts the face, and interferes with normal functions, such as eye closing, drinking, and chewing. It also affects tears, saliva, taste, and hearing. Often, the weakness is short-term and improves over weeks [1]. However, some patients suffer long-term and uneven recovery periods. Therefore, acupuncture interventions aim to promote recovery and minimize the risk of complications and long-term effects. Current research indicates that Bell's palsy can occur at any age, and more often in people who are pregnant, especially during the third trimester, or who are in the first week after giving birth [1], and the treatments are using antivirus and steroids. It is not much research done on Bell's palsy in pregnant women or postpartum women with acupuncture treatment. In this case study, we report two cases of such women being treated with acupuncture to explore the possible mechanism. Case 1. 32 years old female with 34 weeks (about eight months) pregnant has had a sudden onset of left-side face muscle weakness; her half of the left face appears to droop, the smile is one-sided, left side upper and lower lip were weak, leaking of water, and the eye on the left side is hard to close and feel dryness.
She was taking one-week antivirus medication and prednisone from her primary doctor. Week 2 (July 10,2024), she started acupuncture treatment twice weekly. After four visits, she felt her left facial muscles begin to move. After six weeks (11 visits) her left facial muscles are getting stronger, appearing almost symmetrical smile. Her left eye closes almost normally. Treatment is still in progress. Case 2. A 33-year-old female suddenly had weakness in her right face for three days after giving birth; her right-side face appeared to droop. Smiles are one-sided. The right side upper and lower lip were weak, leaking water from the right side, while the eye on the right side was hard to close and felt dry. She was taking one week antivirus medication and prednisone from her primary doctor. Week 2(Sept.21,2021), she started acupuncture treatment twice a week. After 8 weeks (12 visits) her right face muscles are getting stronger and appearing almost symmetrical smile. Her right eye closed normally. Points selection and treatment method:
1. Frontalis muscles area ：Yang bai (GB14) ; Zhanzhu (BL2), Yuyao
2. Orbicularis oculi: Sizhukong( Sj 23), Tongziliao(GB1), points under eye brow，Chengqi(St 1), Sibai (St2).
3. Cheek: Juliao (St 3), Dicang (St 4), Daying (St 5), Jiache(St6), Quanliao (Si 18)
4. Facial nerve behind the earlobe： YiFeng（Sj 17）
5. Distant point: He Gu (LI4), Taichong(Liv 4), Zusanli( St36)
After cleaning the skin, insert the needles to select points and connect two pairs of needles to the electroacupuncture machine for 30 minutes, using a sparse wave and dense wave alternating low frequency. Acupuncture was administered supine on the treatment table while the patients' eyes closed. After cleaning the skin, the needles were inserted to points by oblique, flat, or straight insertion depending on various points location. The needles were then retained for 30 minutes without any manipulation. Two pairs of needles (one was around eyebrow/ forehead, another one was around cheek/ mouth) were connected to the electroacupuncture machine for 30 minutes, using a sparse wave and dense wave alternating low frequency. After the needle removal, a cotton swab was used to press the needled region for 3-5 minutes to prevent bruising. Discussion： The results indicate that this protocol produces a highly positive outcome with pregnant and postpartum mother with Bell’s palsy. According to Traditional Chinese Medicine, facial paralysis is known as 'deviated mouth'. It was attributed to a 'wind' attack. 'Qi' refers to vital substances. It maintains life activities and reflects the resistance of the human body. Deficiency of 'qi' allows the invasion of exogenous pathogenic wind。 Acupuncture is part of Traditional Chinese Medicine and dates back thousands of years. It involves inserting fine needles into specific points on the skin or applying various other techniques to the acupuncture points to bring about healing. In Bell's palsy, acupuncture treatment might have numerous beneficial effects, such as recovering facial muscle function and reducing stress and anxiety. Acupuncture treatment for pregnancy and postpartum women with Bell’s palsy will potentially reduce the side effects of antivirus and steroids on the babies (breast feeding) and safely help the recovery of facial nerves. Therefore, further trials on pregnant and postpartum women with acupuncture for Bell’s Palsy should be explored; a double-blinded studies are necessary [2]. Reference：
1. Bell's palsy - Symptoms and causes - Mayo Clinic
2. Efficacy of Acupuncture for Bell's Palsy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials