1. Auricular & Scalp Acupuncture Review ACR class 13

2. Auricular

3. Anatomy & Somatatopic Representation

6. Modern Auriculotherapy founded by Paul Nogier in 1950‘s France Also developed in 1960’s China Some differences in point location but overall very similar Fetal / “Upside-down man” representation

7. Lobe: Face & sensory Antitragus: Cranial & brain Internal organs in concha: Thorax = Inferior (Cavum) concha Abdomen = Superior (Cymba) concha Digestive = around helix crus

8. Spine on antihelix Upper limb on scaphoid fossa Lower limb on upper antihelix crus Triangular fossa = Chinese: Reproductive & Shenmen; French: Lower limb

9. Lobe: Cranial area/face/sensory on lobe Internal organs in concha Spine on antihelix Upper limb on scaphoid fossa Lower limb on upper antihelix crus Triangular fossa = Chinese: Reproductive & Shenmen; French: Lower limb

14. NADA Protocol AKA: 5-Needle Protocol, 5NP Most common auricular protocol used today Use for addictions, trauma, pain, etc

16. Shen Men: Slightly superior and anterior to the tip of the triangular fossa. Sympathetic-Autonomic point: Junction of the internal helix and the inferior antihelix crus. It is covered by the fold of the helix. Liver: Junction of the concha ridge/helix crus with the posterior concha wall (just anterior to antihelix). Some maps place it slightly superior to the concha ridge.

17. Kidney: In superior concha, near concha wall, directly below Shen Men. Lung 2: In lower part of inferior concha, just below deepest part of concha (Heart point).

19. Diagnosis Ear probe - look for painful points Electronic point finder - low skin resistance Visual inspection - Discoloration

20. Treatment Filiform needles Press tacks or intradermals Seeds Bleeding Ear massage Electric stim Cold laser

21. Needling Disinfect skin with alcohol Use 15mm, 7mm or press tack Filiform needle retain 20-40 minutes Check for bleeding on removal of needle

22. Precautions Do not needle if external ear is infected or inflamed Contraindicated for pregnancy with history of miscarriage; caution otherwise Caution weak constitution Do not leave tacks or seeds more than 1 week

23. Scalp Acupuncture

24. Several different systems: Jiao, Zhu, Yamamoto (YNSA), etc Jiao system most common Scalp Acupuncture

28. Motor Area Location: Locate the upper point 0.5 cm posterior to the mid-point of the anterior-posterior midline. Then locate the lower point at the intersection of the eyebrow-occiput line with the anterior temporal hairline. The line connecting the upper and lower points is the motor area. This line is divided into five equal portions.

29. Motor Area Lower limb and trunk area Location: Upper 1/5 of the motor area. Indications: Contralateral paralysis of the lower limbs. Upper limb area Location: Middle 2/5 of the motor area. Indications: Paralysis of the upper limbs. Facial area Location: Lower 2/5 of the motor area. Indications: Facial paralysis, motor aphasia, salivation, impaired speech, and dysphonia.

30. Sensory Area Location: The line parallel to and 1.5 cm posterior to the motor area. Divide this line into five equal portions. Lower limb, head, and trunk area Location: Upper 1/5 of sensory area. Indications: Contralateral lumbar pain, leg pain, numbness, paresthesia, occipital headache, neck pain, tinnitus. Upper limb area Location: Middle 2/5 of the sensory area. Indications: Upper limb pain, numbness, paresthesia. Facial area Location: Lower 2/5 of the sensory area. Indications: Facial numbness, migraine, trigeminal neural- gia, toothache, temporomandibular arthritis.

31. Chorea & Tremor Control Area Location: Parallel and 1.5 cm anterior to the motor area. Indications: Chorea, Parkinson’s disease. Blood vessel dilation and constriction area Location: Parallel and 1.5 cm anterior to the chorea and tremor control area. Indications: Superficial edema, hypertension.

32. Vertigo and hearing area Location: A horizontal line 1.5 cm above the ear apex; 2 cm anterior and 2 cm posterior (total 4.0 cm length). Indications: Tinnitus, vertigo, diminished hearing, Meniere’s syndrome. Speech 3 Location: A horizontal line starting at the midpoint of the Vertigo and Hearing Area and running posteriorly 4.0 cm in length. Indications: Sensory aphasia.

33. Speech 2 Location: A vertical line 2.0 cm posterior and inferior to the parietal tubercle 3.0 cm in length. Indications: Nominal aphasia. Voluntary Movement / Usage area Location: At the parietal tubercle origin, three lines run inferiorly, anteriorly, and posteriorly 3.0 cm each with a 40° angle between each of the lines. Indications: Apraxia.

35. Foot Motor and Sensory Area Location: Two lines 1.0 cm lateral to the midpoint of the anterior-posterior midline 3.0 cm in length posterior and parallel to the midline. Indications: Contralateral lower limb pain, numbness, paralysis, acute lumbar sprain, nocturia, and uterine prolapse.

37. Vision area Location: Two lines 1.0 cm lateral to the midpoint of the external occipital protuberance, parallel to the anterior-posterior midline, 4.0 cm in length extending superiorly. Indications: Visual disturbances, cortical blindness. Balance area Location: Two lines 3.5 cm lateral to the midpoint of the external occipital protuberance, parallel to the anterior-posterior midline, 4.0 cm in length extending inferiorly. Indications: Loss of balance due to cerebellar disorders, dizziness.

39. Stomach area Location: Beginning at the hairline directly superior to the pupil of the eye, parallel with the anterior-posterior midline, 2.0 cm in length bilaterally extending posteriorly. Indications: Stomach / epigastric pain. Thoracic cavity Location: Beginning 2.0 cm below the hairline, midway between and parallel to the stomach area and the anterior- posterior midline, 4.0 cm in length bilaterally extending superiorly. Indications: Chest pain, palpitations, coronary heart disease, asthma, and hiccups.

40. Reproduction area Location: Beginning at the hairline, a line 2.0 cm in length from the frontal angle extending posteriorly and parallel to the anterior-posterior midline. Indications: Functional uterine bleeding, pelvic inflammation, leukorrhea, and uterine prolapse.

41. Liver and Gallbladder Area Location: Beginning at the hairline, a line 2.0 cm in length from the stomach area extending inferiorly. Indications: Upper right quadrant abdominal pain, chronic hepatitis, abdominal pain due to liver and gallbladder disease. Intestine Area Location: Beginning at the hairline, a line 2.0 cm in length from the reproduction area extending inferiorly. Indications: Lower abdominal pain.

42. Needle Technique Clean insertion site with alcohol Use 1-2 cun filiform needles, 28-32 gauge Insert 30 angle, thread into aponeurosis Twirling manipulation, up to 200x/minute Manipulate 2-3 minutes, rest 5-10 minutes and repeat 2-3 times; or use high frequency e-stim (200-300 hz)

43. Precautions Seated or lying position; watch for fainting Not advisable for weak patients, high fever, local inflammation, heart failure Contraindicated if open head wounds or intracranial bleeding; wait until bleeding has stopped and patient is stable