Bell's Palsy (Facial Paralysis)
Overview
Bell's palsy, known in TCM as 'wry mouth and eye' or 'dangling thread wind,' is characterized by deviation of the mouth and eye to one side. The disease is located in the facial meridians and is closely related to the sinew meridians of Hand and Foot Yangming and Hand and Foot Shaoyang. It usually arises from insufficient healthy qi and insecure defensive exterior, allowing wind pathogen to invade the facial meridians, causing qi and blood stagnation, malnutrition of sinews, and flaccidity of muscles. Common patterns include wind-cold, wind-heat, and qi-blood deficiency with stasis. Early treatment focuses on dispelling wind and unblocking collaterals; later stages emphasize benefiting qi, nourishing blood, and invigorating blood to unblock collaterals. Acupuncture is the treatment of choice, and combined with oral Chinese herbs can enhance efficacy.
Pattern differentiation (clinical patterns)
Wind-Cold Attacking the Collaterals
Sudden deviation of mouth and eye, tightness of facial muscles, pain behind the ear, aversion to cold with fever, no sweating, headache, nasal congestion with clear discharge, pale red tongue with thin white coating, and a floating tight pulse.
Dispel wind and scatter cold; unblock the collaterals and restore facial alignment.
Wind-Heat Invading the Collaterals
Deviation of mouth and eye, flaccid facial muscles, pain behind the ear, fever predominant over aversion to cold, sore throat, dry mouth with mild thirst, red tongue edges and tip with thin yellow coating, and a floating rapid pulse.
Disperse wind and clear heat; unblock the collaterals and restore facial alignment.
Qi and Blood Deficiency with Stasis
Prolonged deviation of mouth and eye that does not heal, facial muscle atrophy, numbness, fatigue, lusterless complexion, pale dark tongue possibly with petechiae, thin white coating, and a fine weak or choppy pulse.
Benefit qi and nourish blood; invigorate blood and unblock the collaterals.
Connections
Daily care & prevention
Keep the face warm and avoid direct wind-cold exposure. Apply a warm towel to the affected side of the face 2-3 times daily. Perform facial exercises such as puffing cheeks, frowning, closing eyes, and showing teeth. Eat a light, easily digestible diet and avoid spicy, greasy foods. Maintain a relaxed mood and avoid fatigue. Wear an eye patch during sleep to protect the cornea on the affected side.
When to seek medical care
If ear herpes or severe ear pain appears, it suggests herpes zoster virus and requires timely antiviral treatment. If facial paralysis is accompanied by limb weakness, slurred speech, or difficulty swallowing, be alert to central lesions and seek immediate medical attention. If there is no sign of recovery after three months, further evaluation is needed.