[Acupuncture and moxibustion for peripheral facial palsy at different stages: multi-central large-sample randomized controlled trial].

OBJECTIVE: To explore the best intervention time of acupuncture and moxibustion for peripheral facial palsy (Bell's palsy) and the clinical advantage program of selective treatment with acupuncture and moxibustion. METHODS: Multi-central large-sample randomized controlled trial was carried out. Nine hundreds cases of Bell's palsy were randomized into 5 treatment groups, named selective filiform needle group (group A), selective acupuncture + moxibustion group (group B), selective acupuncture + electroacupuncture (group C), selective acupuncture + line-up needling on muscle region of meridian group (group D) and non-selective filiform needle group (group E). Four sessions of treatment were required in each group. Separately, during the enrollment, after 4 sessions of treatment, in 1 month and 3 months of follow-up after treatment, House-Brackmann Scale, Facial Disability Index Scale and Degree of Facial Nerve Paralysis (NFNP) were adopted for efficacy assessment. And the efficacy systematic analysis was provided in view of the intervention time and nerve localization of disease separately. RESULTS: The curative rates of intervention in acute stage and resting stage were 50.1% (223/445) and 52.1% (162/311), which were superior to recovery stage (25.9%, 35/135) separately. There were no statistical significant differences in efficacy in comparison among 5 treatment programs at the same stage (all P > 0.05). The efficacy of intervention of group A and group E in acute stage was superior to that in recovery stage (both P < 0.01). The difference was significant statistically between the efficacy on the localization above chorda tympani nerve and that on the localization below the nerve in group D (P < 0.01). The efficacy on the localization below chorda tympani nerve was superior to the localization above the nerve. CONCLUSION: The best intervention time for the treatment of Bell's palsy is in acute stage and resting stage, meaning 1 to 3 weeks after occurrence. All of the 5 treatment programs are advantageous to Bell's palsy. In the condition of the limited medical sources, the simple filiform needle therapy is recommended in acute stage. For the patients with the disorder above chorda tympani nerve, the line-up needling on muscle region of meridian is not recommended.

[Comparison of therapeutic effects of peripheral facial paralysis in acute stage by different interventions].

OBJECTIVE: To compare the therapeutic effects of peripheral facial paralysis in acute stage by different interventions and explore the better treatments of peripheral facial paralysis. METHODS: One hundred and thirty one cases of Bell's facial paralysis were randomly divided into three groups. In acupuncture group (44 cases), Dicang (ST 4), Jiache (ST 6), Hegu (LI 4), Yangbai (GB 14) and Taiyang (EX-HN 5), etc. were applied; in electroacupuncture group (45 cases), the selection of acupoints and needling method were same as those in acupuncture group, and the electroacupuncture therapy was applied on Dicang (ST 4), Xiaguan (ST 7), Yangbai (GB 14) and Taiyang (EX-HN 5) in acute stage; in medication and acupuncture group (42 cases), Prednisone and Acyclovir were taken by oral administration, Vitamin B1 and Vitamin B12, were applied by intramuscular injection in acute stage, and acupuncture was applied by the way which was same as that in acupuncture group during quiescent and recovery stages. The curative effects were evaluated by House-Brackmann Grading Scale, and the failed rates were observed by follow-up after one and three months. RESULTS: The cured and markedly effective rates were 79.6% (35/44), 93.4% (42/45) and 78.6% (33/42) respectively in acupuncture group, electroacupuncture group and medication and acupuncture group, and the result in electroacupuncture group was superior to those in acupuncture group and medication and acupuncture group (P < 0.05). The cured rates above tympanichord were 54.2% (13/24), 85.2% (23/27) and 48.0% (12/25) in acupuncture group, electroacupuncture group and medication and acupuncture group, and the result in electroacupuncture group was superior to those in acupuncture group and medication and acupuncture group (P < 0.01). There was no significant differences of cured rates below tympanichord among three groups (P > 0.05); and the failed rate in electroacupuncture group was much lower than those in acupuncture group and medication and acupuncture group by follow-up after one and three months (all P < 0.01). CONCLUSION: The peripheral facial paralysis is effectively treated by electroacupuncture in acute stage, and it suggests that electroacupuncture should be applied early during the acupuncture treatment of peripheral facial paralysis.

[Clinical observation on therapeutic effect of different acupuncture therapies on acute peripheral facial paralysis].

OBJECTIVE: To explore the better therapeutic method for acute peripheral facial paralysis. METHODS: One hundred and ninety-seven cases of acute peripheral facial paralysis were randomly divided into an observation group (n=125) and a control group (n=72). The observation group was treated by injection at acupoint combined with warming needle therapy at Yifeng (TE 17), Wangu (GB 12), Xiaguan (ST 7), Qianzheng (EX), and Taiyang (EX-HN 5). The control group was treated with electroacupuncture at Yifeng (TE 17), Yangbai (GB 14), Xiaguan (ST 7), etc. Their therapeutic effects were compared between the two groups. RESULTS: After three therapeutic courses, the cured rate and the total effective rate in the observation group were 76.0%, 100.0%, and 48.6%, 86.1% in the control group, respectively, with significant defferences between the two groups (all P < 0.01). CONCLUSION: Injection at acupoint combined with warming needle therapy could shorten the therapeutic cycle, improve the effectiveness, and decrease sequela in acute peripheral facial paralysis.

[Experience of professor Sun Liuhe in treating facial peripheral paralysis].

Professor Sun Liuhe is engaged in medical service for over 40 years. He is deeply involved in research on intractable and complicated diseases. Especially, in treating facial paralysis, he makes diagnosis and treatment based on overall analysis of symptoms and causes, differentiation of syndrome for etiology. Without confining himself to ancient treatment methods, by applying both acupuncture and Chinese medicine, selecting auxiliary acupoints according to differentiation of meridians related to illness, as well as considering anatomy. Professor Sun holds ancient and modern therapeutic methods, brings forth ideas of using new acupoints to prevent perversion based on pulse tracings, and uses cutting therapy for the cases suffering from facial paralysis for a long time. This method can shorten treatment courses, to a great extent, and achieve good therapeutic effects on intractable facial paralysis, which has revealed distinctness of acupuncture therapy.

Neuroanatomical basis of acupuncture treatment for some common illnesses.

The acupuncture treatment formulae for some common conditions are reviewed. These conditions include low back pain, sciatica, trigeminal neuralgia, facial nerve palsy, asthma, nausea and vomiting, gastritis and dysmenorrhoea. It is found that in many cases, the acupuncture points traditionally used for the treatment have a neuroanatomical significance from the viewpoint of Western medicine. And from that one can hypothesise a plausible mechanism of action as to how acupuncture achieves its therapeutic effects in terms of contemporary Western medicine. These mechanisms of action include intramuscular stimulation for treating muscular pain and nerve stimulation for treating neuropathies. The sympathetic ganglion may be involved in the acupuncture treatment of asthma. Somato-autonomic reflex may be responsible for the acupuncture effect on gastritis.

Laqve (wry mouth) considered in Avicenna's renowned treatise the Canon of Medicine.

Hemi-facial spasm, facial paralysis, and trigeminal neuralgia are prevailing signs and symptoms with which physicians have been coping for thousands of years. Ibn Sina (known as Avicenna in the West), who was among the leading figures during medieval ages and influenced the upcoming periods in the Eastern and Western hemispheres for long time, focused also on these crucial problems. In his principal medical work, the Canon of Medicine, Avicenna underlined the significance of wry mouth-related disorders and wrote a precise chapter over this topic with the heading "Laqve." However, the term "laqve" is usually accepted only as facial paralysis in most of historical texts. Further detailed analysis of the text reveals that, all the above-mentioned signs and symptoms are considered under the same heading. Therefore, the descriptions articulated by famous physician Avicenna pose great merit from the point of historical view of neurological sciences. The main aim of this article is to reintroduce essential parts of the text by adding comments over specific descriptions, and consequently, to make the text more comprehensible for today's scientists.

A method of selecting acupoints for acupuncture treatment of peripheral facial paralysis by thermography.

The purpose of this study is to select acupoints for acupuncture treatment of peripheral facial paralysis according to the temperature on the face of the patient detected by thermogram, to determine an objective acupoint selection method for acupuncture treatment. In the test group of 60 cases of facial paralysis, the infrared thermogram on the face was detected at the first visit, and then acupuncture was given at the acupoints on the affected side with a temperature difference of over 0.5 degrees C from the healthy side for one therapeutic course, and in each successive course the acupoints were re-determined according to the results of thermogram examination and were administrated till the end of the total therapeutic course, and 120 cases of the control group were treated with acupuncture at conventionally selected acupoints. The results showed that the cured and basically cured rate was 90.0% (54 cases) in the test group and 77.5% (93 cases) in the control group with a significant difference between the two groups (p < 0.05); and the total sessions of acupuncture were less and the course of treatment was shorter in the test group than those in the control group (both p < 0.001). The utilization rate of the acupoints selected by facial thermogram in the test group was in order of Dicang (ST 4, 92.3%), Yingxiang (LI 20, 90.6%), Taiyang (EX-HN 5, 85.5%), Yangbai (GB 14, 76.6%), Quanliao (SI 18, 72.3%), and so on. In conclusion, acupuncture at the acupoints selected by thermogram for treatment of facial paralysis in the cured rate, the therapeutic course and sessions of acupuncture is significantly superior to acupuncture at the conventionally selected acupoints, and the thermogram-aided acupoint selection method is beneficial to objectivity and modernization of acupoint selection for acupuncture and moxibustion treatments.

Malformaciones y parálisis faciales en la cerámica de las culturas precolombinas Moche y Lambayeque / Evidence of facial palsy and facial malformations in pottery from Peruvian Moche and Lambayeque pre-Columbian cultures

Introducción. Las culturas Moche (100-700 d.C.) y Lambayeque o Sicán (750-1100 d.C.) son culturas precolombinas pertenecientes al período de los estados regionales que se desarrollaron en el norte de Perú. Se ha obtenido abundante información sobre la vida cotidiana, la religión y la medicina mediante el estudio de las cerámicas encontradas en los entierros de los señores y sacerdotes Moche en las huacas, pirámides y templos sagrados. Objetivo. Describir las evidencias arqueológicas de la medicina Moche y las enfermedades neurológicas mostradas en sus restos cerámicos. Material y métodos. Estudiamos las representaciones de las enfermedades en la iconografía y cerámicas Moche y Lambayeque expuestas en el Museo Arqueológico Casinelli de Trujillo y el Museo Arqueológico Nacional Brüning de Lambayeque, Perú. Se documentaron fotográficamente los casos más llamativos previa autorización de las autoridades de los museos. Resultados. Observamos cerámicas que representan sujetos afectos de parálisis facial periférica, malformaciones faciales (labio leporino), un posible espasmo hemifacial, pacientes con amputaciones de brazos y pies, sujetos siameses y sujetos con cifoescoliosis. También observamos vasos ceremoniales de los médicos Moche, hombre y mujer, tratando a los enfermos. Conclusiones. Las principales entidades representadas en la cerámica Moche y Lambayeque son la parálisis facial periférica y las malformaciones faciales de tipo labio leporino. Estas representaciones constituyen uno de los primeros registros de estas patologías en las culturas precolombinas de Sudamérica (AU)

INTRODUCTION: Moche (100-700 AD) and Lambayeque-Sicán (750-1100 AD) are pre-Columbian cultures from Regional States Period, developed in Northern Peru. Information about daily life, religion and medicine has been obtained through the study of Moche ceramics found in lords and priests tombs, pyramids and temples. OBJECTIVE: To analyze archeological evidences of Moche Medicine and neurological diseases through ceramics. MATERIAL AND METHODS: Representations of diseases in Moche and Lambayeque iconography and Moche pottery collections exposed in Casinelli museum from Trujillo, and Brüning National Archeological museum from Lambayeque, Peru, were studied. The most representative cases were analyzed and photographed, previous authorization from authorities and curators of the museums. RESULTS: The following pathologies were observed in ceramic collections: peripheral facial palsy, facial malformations such as cleft lip, hemifacial spasm, legs and arm amputations, scoliosis and Siamese patients. Male and females Moche doctors were also observed in the ceramics in ritual ceremonies treating patients. CONCLUSIONS: The main pathologies observed in Moche and Lambayeque pottery are facial palsy and cleft lip. These are one of the earliest registries of these pathologies in pre-Columbian cultures in South-America (AU)

[Evidence of facial palsy and facial malformations in pottery from Peruvian Moche and Lambayeque pre-Columbian cultures]. / Malformaciones y parálisis faciales en la cerámica de las culturas precolombinas Moche y Lambayeque.

INTRODUCTION: Moche (100-700 AD) and Lambayeque-Sicán (750-1100 AD) are pre-Columbian cultures from Regional States Period, developed in Northern Peru. Information about daily life, religion and medicine has been obtained through the study of Moche ceramics found in lords and priests tombs, pyramids and temples. OBJECTIVE: To analyze archeological evidences of Moche Medicine and neurological diseases through ceramics. MATERIAL AND METHODS: Representations of diseases in Moche and Lambayeque iconography and Moche pottery collections exposed in Casinelli museum from Trujillo, and Brüning National Archeological museum from Lambayeque, Peru, were studied. The most representative cases were analyzed and photographed, previous authorization from authorities and curators of the museums. RESULTS: The following pathologies were observed in ceramic collections: peripheral facial palsy, facial malformations such as cleft lip, hemifacial spasm, legs and arm amputations, scoliosis and Siamese patients. Male and females Moche doctors were also observed in the ceramics in ritual ceremonies treating patients. CONCLUSIONS: The main pathologies observed in Moche and Lambayeque pottery are facial palsy and cleft lip. These are one of the earliest registries of these pathologies in pre-Columbian cultures in South-America.

Acute pathological laughter.

Pseudobulbar affect is a condition characterized by uncontrollable episodes of inappropriate laughing or crying that are disproportionate and discordant to the situation at hand. We report on a 16-year-old woman presenting with acute pathological laughter in the context of CNS demyelinating disease. Brain MRI scans fortuitously obtained before and after the onset of this symptom demonstrated acute gadolinium-enhancing lesions in the cerebral peduncles. The etiology of this condition remains theoretical; however, the results here provide further insights into the pathways of emotional control.