1. Acupuncture Treatment of Diseases Neurology 5: Facial Pain 面痛

2. Definition: 1.Also called “facial wind pain”. 2.Mainly manifested as radiating, scorching and spastic pain in the region of the eye and cheeks. 3.Often attacks one side of the face and is seen in people 40-60 year old, especially in woman 4.Facial pain is Trigeminal neuralgia in western medicine.

3. Causes and Pathogenesis : 1.Invasion by external evils: Wind-cold invades the channel of yang-ming and tai- yang in the face resulting coagulation and contraction of the tendons and channels leading to obstruction of qi and blood. Wind-heat accumulates and obstructs in the channel and prevents the free flow of qi and blood. 2.From stirring up of stagnant heat due to emotional disturbance or 3.From the hyperactive yang and inflamed deficient fire due to yin deficiency. 4.Local external injury and other prolonged diseases may block the local collaterals and lead to stagnation of qi and blood.

4. Clinical Manifestations: Chief symptoms: i.Facial spasm consisting of severe cutting or scorching pain in the facial region. ii.Flushed complexion. iii.Lacrimation and salivation. iv.Often evoked by speaking, swallowing, face washing, cold stimulation or emotional instability. v.Pain can last for seconds to minutes. vi.The frequency and times of its onset are not fixed. vii.No symptoms in the periods of intermission.

5. Clinical Manifestations: 1.Wind-cold type Stated manifestations with: i.History of wind-cold contraction. ii.Facial pain aggravated by cold and alleviated by warmth. iii.Clear nasal discharges. iv.Light coloured tongue. v.Thin white tongue coating. vi.Floating, tight pulse.

6. Clinical Manifestations: 2.Wind-heat type Stated manifestations with: i.Burning sensation in the region of pain. ii.Salivation. iii.Red eyes and lacrimation. iv.Red tongue. v.Thin yellow tongue coating. vi.Floating, rapid pulse.

7. Clinical Manifestations: 3.Stagnant heat in liver type i.Restlessness and irritability. ii.Thirst. iii.Constipation. iv.Red tongue with yellow coating. v.Rapid pulse.

8. Clinical Manifestations: 4.Hyperactive yang due to yin deficiency type i.Emaciation. ii.Flushed cheek. iii.Red tongue with thin yellow coating. iv.Thready, rapid pulse.

9. Clinical Manifestations: 5.Qi stagnation and blood stasis type i.Fixed location of pain. ii.Dark tongue with ecchymosis. iii.Thready, rough pulse. iv.History of external injury or prolong course.

10. Treatment : General principle Dredge the channels of the face. Relieve pain and muscular spasm. Dispel wind and external evils and remove obstructions. Principle channels: 1.Bladder channel. 2.Stomach channel. 3.Large intestine channel. 4.Gall Bladder channel.

11. Principle acupoints : 1.BL 2 Cuanzhu 攒竹. 2.ST 2 Sibai 四白. 3.ST 4 Dicang 地仓. 4.ST 6 Jiache 颊车. 5.ST 7 Xiaguan 下关. 6.LI 4 Hegu 合谷. 7.GB20 Fengchi 风池.

12. Prescription explanation (Principle acupoint): 1.BL 2 Cuanzhu 攒竹, ST 2 Sibai 四白, ST 4 Dicang 地仓, ST 6 Jiache 颊车, ST 7 Xiaguan 下关 : Channel acupoint of the BL, ST channel, chosen to dredge the channel of the face. 2. LI 4 Hegu 合谷： Yuan-Source acupoint of the LI channel where qi of the organ originates, passes and stays, chosen to relieve pain and as a key point to disorders of the face and the mouth. 3.GB 20 Fengchi: Channel acupoint of the GB channel, chosen to dispel wind and remove obstructions of the channel.

13. Principle of treatment 1.Wind cold type: Smooth and dredge channel, relieve pain and spasm and dispel wind and cold. Principle acupoints: as stated Supplementary acupoints: 1.BL 12 Fengmen 风门. 2.LU 7 Lieque 列缺.

14. Principle of treatment 2.Wind heat type: Smooth and dredge channel, relieve pain and spasm dispel wind and heat. Principle acupoints: as stated Supplementary acupoints: 1.LI 11 Quchi 曲池. 2.LU 5 Chize 尺泽.

15. Principle of treatment 3.Stagnant heat in liver type: Smooth and unblock channel, relieve pain and spasm, dispel heat. Principle acupoints: as stated Supplementary acupoints: 1.LR 3 Taichong 太冲.

16. Principle of treatment 4.Hyperactive yang due to yin deficiency type: Smooth and dredge channel, relieve pain and spasm, suppress yang and nourish yin. Principle acupoints: as stated Supplementary acupoints: 1.LR 3 Taichong 太冲. 2.KI 3 Taixi 太溪.

17. Principle of treatment 5.Qi stagantion and Blood stasis type: Smooth and unblock channel, relieve pain and spasm, invigorate blood. Principle acupoints: as stated Supplementary acupoints: 1.SP 6 Sanyinjiao 三阴交. 2.BL 17 Geshu 膈俞.

18. Supplementary acupoints: ophthalmic pain. 1.TE 23 Sizhukong 丝竹空. 2.EX-HN 4 Yuyao 鱼腰. 3.GB 14 Yangbai 阳白. Supplementary acupoints: for pain in the upper mandible. 1.SI 18 Quanliao 颧髎. 2.LI 20 Yingxiang 迎香. Supplementary acupoints: for pain in the lower mandible.. 1.CV24 Chengjiang 承浆. 2.TE 17 Yifeng 翳风.

19. TCM medical advises: 1.Avoid emotion stress. 2.Avoid exposure to wind and cold. 3.Regular light diet habit avoiding raw, cold and greasy, pungent and spicy food.